Paroxysmal Disorders (epilepsy) Flashcards
What are paroxysmal disorders?
Disorders in which the nervous system functions normally between episodes, such as seizures, headaches, and fainting
What is another name for paroxysmal disorders?
Episodic disorders.
What are common triggers for paroxysmal disorders?
Stress and fatigue.
What is a seizure?
- A paroxysmal hyper-synchronous abnormal activity of neurons
- Sudden and transient interruption of brain function due to disruption of electrochemical processes in transmitting information from one nerve cell to another
What is epilepsy?
A condition diagnosed by at least two unprovoked (idiopathic) seizures more than 24 hours apart.
How common is epilepsy globally?
It is the most common neurological disorder worldwide.
What percentage of people will experience a one-off seizure in their lifetime?
Approximately 1 in 20 people.
At what stages of life is epilepsy more likely to begin?
In childhood or later life.
What impact does epilepsy have on children’s education?
It can significantly impact education, with one-third of affected children experiencing ongoing seizures.
What is idiopathic epilepsy?
Epilepsy with no identifiable cause.
What is symptomatic epilepsy?
Epilepsy caused by identifiable factors like brain injury, infection, or tumours
What are some common causes of seizures in adults and elderly individuals?
Vascular diseases, head trauma, infections, tumors, and alcohol or drug misuse.
What percentage of stroke patients develop seizures?
About 10%.
What is the seizure risk after a subarachnoid bleed?
Around 30%
What are the two main types of seizures?
Focal (partial) and generalised seizures.
What are focal seizures?
Seizures starting in a specific brain region; they can be simple (consciousness preserved) or complex (altered consciousness).
What are generalized seizures?
Seizures affecting the entire brain, leading to a loss of consciousness.
Name 4 common types of generalized seizures.
Tonic-clonic, absence, myoclonic, and atonic seizures.
Where do focal seizures usually start?
In a specific part of the brain, such as the temporal, frontal, occipital, or parietal lobe.
What happens in a simple focal seizure?
Consciousness is preserved, and the person may experience unusual sensations or twitching.
What happens in a complex focal seizure?
There’s altered consciousness, strange behaviors, and possible confusion after the seizure.
What characterizes tonic-clonic seizures?
Stiffening (tonic phase) followed by rhythmic jerking (clonic phase), often with cyanosis and incontinence.
What is an absence seizure?
A brief seizure where a person stops activity and stares into space, common in children.
What is a myoclonic seizure?
A seizure involving sudden, involuntary muscle jerks.
What is an atonic seizure?
A seizure resulting in a sudden loss of muscle tone.
What questions are helpful to diagnose the type of seizure?
Ask about how the seizure starts, how it evolves, duration, consciousness loss, how it stops, post-seizure symptoms, and recovery time.
What role does EEG play in diagnosing epilepsy?
It records electrical activity in the brain to support diagnosis, although it can be normal in 60-70% of epilepsy cases.
When is a brain scan indicated in epilepsy?
To detect causes like scarring or tumors, typically using MRI.
When should treatment for epilepsy begin?
After a diagnosis of epilepsy, defined by more than two unprovoked seizures.
What is the primary goal of epilepsy treatment?
Complete seizure control with minimal side effects.
What are the main treatments for epilepsy?
Anti-epileptic drugs (AEDs), surgery, ketogenic diet, and complementary therapies.
What percentage of epilepsy cases achieve good seizure control with AEDs?
Around 40% remit and are controlled with AEDs.
What is the prognosis for spontaneous remission of epilepsy?
Approximately 30% remit spontaneously.
Name some conditions that may resemble epilepsy.
Sleep disorders, hyperventilation, migraines, panic attacks, and syncope (fainting).
How can epilepsy vary among individuals?
Seizures differ widely in type, frequency, and triggers.
What are common one-off seizure triggers?
Binge drinking, high fever, and sudden head injury.
What are general characteristics of seizures
Seizures are usually brief, self-limiting, and involve overactivity in the brain’s electrical signals.
What symptoms might someone experience in a simple focal seizure?
Strange sensations like unusual smells or tastes, twitching, and awareness during the seizure.
How does awareness change in a complex focal seizure?
There’s partial loss of awareness, time disorientation, and potentially unusual behavior like lip-smacking or wandering.
What is the ketogenic diet’s role in epilepsy?
It may help reduce or control seizures, particularly in drug-resistant cases.
How does a vagal nerve stimulator work?
It sends electrical pulses to the brain to help reduce seizure frequency.
What is symptomatic epilepsy?
Epilepsy with a clear cause, like brain scarring from an injury or infection.
What is idiopathic epilepsy?
Epilepsy with no obvious cause, sometimes linked to genetic factors
What is an EEG and how does it help in diagnosing epilepsy?
An EEG records brain electrical activity and can show disruptions during a seizure.
Why might brain scans be used in epilepsy diagnosis?
To identify physical causes like scarring or tumors with MRI or CT scans.
How does vascular disease contribute to seizures?
It increases seizure risk, particularly in elderly patients, often following strokes or cerebral bleeds.
What is the risk of seizures after an ischemic stroke?
Approximately 5%.
What is the risk of seizures following a cerebral bleed?
Approximately 20%
What is the seizure risk after a skull fracture?
Approximately 15%.
What is the seizure risk with an intracranial hematoma?
Around 30%.
How soon after head trauma do most seizures occur?
Roughly 75% of trauma-induced seizures happen within the first year after injury
Which infections are linked to seizures?
Viral encephalitis and bacterial meningitis are two common infections that increase seizure risk.
What is the seizure risk after viral encephalitis?
Up to 25%.
What is the seizure risk following bacterial meningitis?
Up to 10%.
How can brain tumors lead to epilepsy?
Tumors disrupt normal brain function and can trigger abnormal electrical activity, leading to seizures.
How does alcohol use contribute to seizures?
Alcohol can cause seizures through toxic effects during binge drinking or during withdrawal.
When are withdrawal seizures most likely to occur after stopping alcohol use?
They typically occur 6–72 hours after cessation, with a peak around 24 hours.
Can drug misuse cause seizures?
Yes, especially with stimulants or drugs that alter brain activity, either directly or through withdrawal.
What are cryptogenic seizures?
Seizures with no identifiable cause, making up approximately 70% of all cases.
How does age influence the causes of seizures?
In older adults, seizures are often caused by strokes or dementia; in younger individuals, genetic and idiopathic factors are more common.
How does stroke lead to epilepsy?
Strokes damage brain tissue, which can create areas of scar tissue that disrupt normal electrical activity, leading to seizures.
What percentage of epilepsy cases are thought to have a genetic component?
While it varies, certain types of epilepsy are thought to have a genetic link, especially idiopathic epilepsy.
