S1_L4: Seizure & Epilepsy Flashcards
In the resolution of epilepsy, the patient has remained seizure-free for the last (1)— and off (2)— for at least the last (3)—
- 10 years
- Anti-seizure medications
- 5 years
Seizure lasting for 1-2 seconds involving the head, trunk, and limbs and the pt falls unexpectedly
Atonic seizure
Match the type of seizure to its characteristics / features
- Occurs in less than 30 seconds
- Shocklike contractions
- Generalized stiffening, clonic movements
- Falling unexpectedly
- Brief jerks of the body without impairment of consciousness
Choices:
A. Atonic seizure
B. Myoclonic seizure
C. Tonic-clonic seizure
D. Absence seizure
- D
- B
- C
- A
- B
Generalized seizures originate at some point within and rapidly engage (1)— distributed networks
- Bilaterally
An important structure that can be part of the network of seizures
Thalamus
Seizure is (1)—-, while epilepsy is (2)—-.
- Event
- Disease
Differentiate provoked and unprovoked seizures.
Provoked: Presence of transient (temporary, reversible) factors that lowers seizure threshold of a normal brain
Unprovoked: Absence of temporary or reversible factors that can lower seizure threshold
Enumerate the 3 conditions of seizure generation
- Population of pathologically excitable neurons
- Increase in excitatory activity through recurrent connections in order to spread the discharge
- Reduction in the activity of the normally inhibitory projections
“Creation of seizure”; Sequence of events that turns a normal neuronal network into a hyperexcitable network in the brain
Epileptogenesis
In normal CNS function, there must be a (1)—- between (2)—- and (3)—- of neurotransmitters.
- balance
- excitation
- inhibition
Glutamate is the major (1)—- neurotransmitter in the CNS, while GABA is the major (2)—- neurotransmitter in the CNS.
- excitatory
- inhibitory
Seizure vs Epilepsy
- Temporary disruptions of brain function, paroxysmal
- Requires extended additional care
- Abnormal event but it does not necessarily depict a disease
- Require chronic treatment
- Repeated and has complications
Choices
A. Epilepsy
B. Seizure
- B
- A
- B
- A
- A
Analogy
fast synaptic transmission : (1)—- ::
slow synaptic transmission : (2)—-
- Ionotropic
- Metabotropic
GABA Receptors
- Ionotropic
- Metabotropic
- Inhibition mediated by K+ current
- Inhibition mediated by Cl- current
- Presynaptic reduction in calcium influx
Choices:
A. GABA A Receptor
B. GABA B Receptor
- A
- B
- B
- A
- B
What are the 2 main glutamate receptors?
AMPA & NMDA receptors
Ancillary procedure / diagnostic tool of choice for seizures?
Electroencephalogram (EEG)
TRUE OR FALSE: Seizures are mainly affecting the cerebral cortex, thus they are cortical.
True.
Originate within networks limited to one hemisphere
Focal Seizures
TRUE OR FALSE: Patients can experience aura before a seizure.
True.
Enumerate the 4 epilepsy types.
Focal, generalized, combined, unknown
Match the EEG finding to its epilepsy syndrome
- Generalized 2 to 2.5 Hz spike and wave discharges
- EEG generalized spike wave discharges that are faster than 3 Hz (4-6)
- Bilateral generalized 3 Hz spike & wave discharges
- Focal spike and wave in the central, parietal and temporal areas
- Bilateral generalized 4-6 Hz spike-wave or polyspike-wave activity
Choices:
A. Juvenile Absence Epilepsy
B. Juvenile Myoclonic Epilepsy
C. West Syndrome
D. Lennox-Gastaut Syndrome
E. Benign Rolandic Seizure / Epilepsy
F. Absence / Petit Mal Epilepsy
- D
- A
- F
- E
- B
This epileptic syndrome is more common in girls
Absence / Petit Mal Epilepsy
Enumerate the 2 epileptic syndromes where boys are more commonly affected.
Lennox-Gastaut Syndrome & Benign Childhood Epilepsy with Centrotemporal Spikes or Benign Rolandic Seizure/Epilepsy
West Syndrome Triad
- Infantile spasms
- Mental retardation (Intellectual disability)
- Hypsarrhythmia on EEG
Lennox-Gastaut Syndrome Triad
- Mixed seizure types
- Developmental disabilities/Mental Retardation (Intellectual disabilities)
- EEG <2.5 Hz spike and wave discharges
A population of pathologically excitable neurons
Hypersynchronizaton
An increase in excitatory activity through recurrent connections in order to spread the discharge and a reduction in the activity of the normally inhibitory projections
Hyperexcitability
increased excitation, decreased inhibition
Hyperexcitability
most common neurological disease globally
Headache
TRUE OR FALSE: Seizures and epilepsy have a bimodal occurrence or distribution, meaning it occurs most frequently in both childhood and old age.
True.
Epilepsy in childhood years was formerly called?
Idiopathic or Primary