(PM3B) Epilepsy Flashcards

1
Q

What percentage of the population are affected by epilepsy?

A

~1%

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2
Q

What is epilepsy?

A

Neuronal hyperexcitability disorder

Arises from excess excitability/ disinhibition

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3
Q

What is disinhibition?

A

Inability to suppress inappropriate behaviour

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4
Q

What are the principle types of seizure?

A

(1) Partial seizures

(2) Generalised seizures

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5
Q

How is epilepsy most often characterised?

A

(1) Convulsions – impairment of motor activity

(2) Impaired consciousness

(3) Impaired perception

(4) Impaired behaviour

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6
Q

What is the most prevalent symptom of epilepsy?

A

Seizures

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7
Q

What is a convulsion?

A

Sudden, violent, irregular movement of a limb or of the body, caused by involuntary contraction of muscles

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8
Q

Is a convulsion the same as a seizure?

A

No

A seizure is a type of convulsion

A seizure is a convulsion due to epileptiform brain activity

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9
Q

Is an isolated seizure considered to be epilepsy?

A

No

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10
Q

What are some possible triggers of an isolated seizure?

A

(1) CNS infection/ inflammation

(2) Stroboscopic lighting

(3) Metabolic dysfunction

(4) Head injury

(5) Fever

(6) Drug-related

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11
Q

How can an isolated seizure be associated with epilepsy?

A

Repeated isolated seizures can increase risk of epilepsy development

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12
Q

What are some co-morbidities of epilepsy?

A

(1) Depression

(2) Anxiety

(3) Cognitive decline

(4) Agitation/ anger

(5) Suicide

(6) ADHD

(7) Reproductive problems

(8) Insomnia

(9) Migraine

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13
Q

What association is there between Alzheimer’s disease and epilepsy?

A

There is an increased prevalence of seizures in patients with AD

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14
Q

What seizure types are there?

A

(1) Generalised

(2) Partial

(3) Secondary generalisation

(4) Simple/ complex

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15
Q

What is a generalised seizure?

A

Involves entire brain

Tonic-clonic/ absence seizures

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16
Q

What is a partial seizure?

A

Involves one specific area of the brain

17
Q

What is a secondary generalisation seizure?

A

Partial seizures which can spread to affect the whole brain

18
Q

What is a simple seizure?

A

A partial seizure

Unimpaired consciousness

19
Q

What is a complex seizure?

A

A partial seizure

Impaired consciousness

20
Q

How is a tonic-clonic seizure characterised?

A

Impairment of consciousness + motor activity

21
Q

How is a myoclonic seizure characterised?

A

Impairment of motor activity ONLY

Jerking of limbs

22
Q

How is an absence seizure characterised?

A

Brief periods of reduced awareness

Impairment of attention + consciousness

23
Q

How is a partial seizure characterised?

A

Depends on lobe affected

Frontal/ parietal/ occipital/ temporal

24
Q

What is a tonic-clonic seizure?

A

(1) Rigidity for approx. 1 minute

(2) Violent jerking of limbs for approx. 2-4 minutes

(3) Feelings of confusion, illness, and disorientation following recovery

25
Q

What is a generalised absence seizure?

A

Occur frequently

Less physically dramatic

Typically stares vacantly ahead, unaware of surroundings

Tends to recover quickly with no after effects

26
Q

What are partial seizures?

A

Remains restricted to a local brain area

Accompanied by simple symptoms

e.g. involuntary movements/ abnormal sensory experiences

Rarely lose consciousness

e.g. Jacksonian epilepsy, psychomotor epilepsy

27
Q

What are the main aims of pharmacological treatment of epilepsy?

A

(1) Reduce number of seizures (ideally to 0)

(2) Maximise quality of life

28
Q

What are the principle treatments for epilepsy?

A

(1) Sodium channel blockers

(2) Enhancement of GABA action

(3) Vagal nerve stimulation

29
Q

Why are sodium channel blockers used in treatment of epilepsy?

A

Prevention of action potential generation

Inhibition prevents/ ameliorates seizures

e.g. phenytoin, carbamazepine, valproate

30
Q

Why are GABA enhancers used in treatment of epilepsy?

A

Enhancement of GABA-mediated Cl- channels

Increases inhibition

Leads to attenuation of seizures

e.g. phenobarbitone, diazepam

31
Q

What are AEDs?

A

Anti-epileptic drugs