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Neurology and Paediactrics > Paroxysmal Disorders (epilepsy) > Flashcards

Paroxysmal Disorders (epilepsy) Flashcards

1
Q

What are paroxysmal disorders?

A

Disorders in which the nervous system functions normally between episodes, such as seizures, headaches, and fainting

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2
Q

What is another name for paroxysmal disorders?

A

Episodic disorders.

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3
Q

What are common triggers for paroxysmal disorders?

A

Stress and fatigue.

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4
Q

What is a seizure?

A
  • 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
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5
Q

What is epilepsy?

A

A condition diagnosed by at least two unprovoked (idiopathic) seizures more than 24 hours apart.

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6
Q

How common is epilepsy globally?

A

It is the most common neurological disorder worldwide.

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7
Q

What percentage of people will experience a one-off seizure in their lifetime?

A

Approximately 1 in 20 people.

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8
Q

At what stages of life is epilepsy more likely to begin?

A

In childhood or later life.

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9
Q

What impact does epilepsy have on children’s education?

A

It can significantly impact education, with one-third of affected children experiencing ongoing seizures.

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10
Q

What is idiopathic epilepsy?

A

Epilepsy with no identifiable cause.

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11
Q

What is symptomatic epilepsy?

A

Epilepsy caused by identifiable factors like brain injury, infection, or tumours

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12
Q

What are some common causes of seizures in adults and elderly individuals?

A

Vascular diseases, head trauma, infections, tumors, and alcohol or drug misuse.

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13
Q

What percentage of stroke patients develop seizures?

A

About 10%.

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14
Q

What is the seizure risk after a subarachnoid bleed?

A

Around 30%

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15
Q

What are the two main types of seizures?

A

Focal (partial) and generalised seizures.

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16
Q

What are focal seizures?

A

Seizures starting in a specific brain region; they can be simple (consciousness preserved) or complex (altered consciousness).

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17
Q

What are generalized seizures?

A

Seizures affecting the entire brain, leading to a loss of consciousness.

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18
Q

Name 4 common types of generalized seizures.

A

Tonic-clonic, absence, myoclonic, and atonic seizures.

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19
Q

Where do focal seizures usually start?

A

In a specific part of the brain, such as the temporal, frontal, occipital, or parietal lobe.

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20
Q

What happens in a simple focal seizure?

A

Consciousness is preserved, and the person may experience unusual sensations or twitching.

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21
Q

What happens in a complex focal seizure?

A

There’s altered consciousness, strange behaviors, and possible confusion after the seizure.

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22
Q

What characterizes tonic-clonic seizures?

A

Stiffening (tonic phase) followed by rhythmic jerking (clonic phase), often with cyanosis and incontinence.

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23
Q

What is an absence seizure?

A

A brief seizure where a person stops activity and stares into space, common in children.

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24
Q

What is a myoclonic seizure?

A

A seizure involving sudden, involuntary muscle jerks.

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25
Q

What is an atonic seizure?

A

A seizure resulting in a sudden loss of muscle tone.

26
Q

What questions are helpful to diagnose the type of seizure?

A

Ask about how the seizure starts, how it evolves, duration, consciousness loss, how it stops, post-seizure symptoms, and recovery time.

27
Q

What role does EEG play in diagnosing epilepsy?

A

It records electrical activity in the brain to support diagnosis, although it can be normal in 60-70% of epilepsy cases.

28
Q

When is a brain scan indicated in epilepsy?

A

To detect causes like scarring or tumors, typically using MRI.

29
Q

When should treatment for epilepsy begin?

A

After a diagnosis of epilepsy, defined by more than two unprovoked seizures.

30
Q

What is the primary goal of epilepsy treatment?

A

Complete seizure control with minimal side effects.

31
Q

What are the main treatments for epilepsy?

A

Anti-epileptic drugs (AEDs), surgery, ketogenic diet, and complementary therapies.

32
Q

What percentage of epilepsy cases achieve good seizure control with AEDs?

A

Around 40% remit and are controlled with AEDs.

33
Q

What is the prognosis for spontaneous remission of epilepsy?

A

Approximately 30% remit spontaneously.

34
Q

Name some conditions that may resemble epilepsy.

A

Sleep disorders, hyperventilation, migraines, panic attacks, and syncope (fainting).

35
Q

How can epilepsy vary among individuals?

A

Seizures differ widely in type, frequency, and triggers.

36
Q

What are common one-off seizure triggers?

A

Binge drinking, high fever, and sudden head injury.

37
Q

What are general characteristics of seizures

A

Seizures are usually brief, self-limiting, and involve overactivity in the brain’s electrical signals.

38
Q

What symptoms might someone experience in a simple focal seizure?

A

Strange sensations like unusual smells or tastes, twitching, and awareness during the seizure.

39
Q

How does awareness change in a complex focal seizure?

A

There’s partial loss of awareness, time disorientation, and potentially unusual behavior like lip-smacking or wandering.

40
Q

What is the ketogenic diet’s role in epilepsy?

A

It may help reduce or control seizures, particularly in drug-resistant cases.

41
Q

How does a vagal nerve stimulator work?

A

It sends electrical pulses to the brain to help reduce seizure frequency.

42
Q

What is symptomatic epilepsy?

A

Epilepsy with a clear cause, like brain scarring from an injury or infection.

43
Q

What is idiopathic epilepsy?

A

Epilepsy with no obvious cause, sometimes linked to genetic factors

44
Q

What is an EEG and how does it help in diagnosing epilepsy?

A

An EEG records brain electrical activity and can show disruptions during a seizure.

45
Q

Why might brain scans be used in epilepsy diagnosis?

A

To identify physical causes like scarring or tumors with MRI or CT scans.

46
Q

How does vascular disease contribute to seizures?

A

It increases seizure risk, particularly in elderly patients, often following strokes or cerebral bleeds.

47
Q

What is the risk of seizures after an ischemic stroke?

A

Approximately 5%.

48
Q

What is the risk of seizures following a cerebral bleed?

A

Approximately 20%

49
Q

What is the seizure risk after a skull fracture?

A

Approximately 15%.

50
Q

What is the seizure risk with an intracranial hematoma?

A

Around 30%.

51
Q

How soon after head trauma do most seizures occur?

A

Roughly 75% of trauma-induced seizures happen within the first year after injury

52
Q

Which infections are linked to seizures?

A

Viral encephalitis and bacterial meningitis are two common infections that increase seizure risk.

53
Q

What is the seizure risk after viral encephalitis?

A

Up to 25%.

54
Q

What is the seizure risk following bacterial meningitis?

A

Up to 10%.

55
Q

How can brain tumors lead to epilepsy?

A

Tumors disrupt normal brain function and can trigger abnormal electrical activity, leading to seizures.

56
Q

How does alcohol use contribute to seizures?

A

Alcohol can cause seizures through toxic effects during binge drinking or during withdrawal.

57
Q

When are withdrawal seizures most likely to occur after stopping alcohol use?

A

They typically occur 6–72 hours after cessation, with a peak around 24 hours.

58
Q

Can drug misuse cause seizures?

A

Yes, especially with stimulants or drugs that alter brain activity, either directly or through withdrawal.

59
Q

What are cryptogenic seizures?

A

Seizures with no identifiable cause, making up approximately 70% of all cases.

60
Q

How does age influence the causes of seizures?

A

In older adults, seizures are often caused by strokes or dementia; in younger individuals, genetic and idiopathic factors are more common.

61
Q

How does stroke lead to epilepsy?

A

Strokes damage brain tissue, which can create areas of scar tissue that disrupt normal electrical activity, leading to seizures.

62
Q

What percentage of epilepsy cases are thought to have a genetic component?

A

While it varies, certain types of epilepsy are thought to have a genetic link, especially idiopathic epilepsy.

Neurology and Paediactrics (3 decks)

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