Seizure

Question 1

what type of neurotransmitter is glutamate?

Answer 1

excitatory

Question 2

seizure is caused by _____ (neurotransmitter) and/or dysfunction of __ &___ receptors

Answer 2

excessive glutamate
dysfunction of the NMDA, AMPA receptors

Question 3

receptors for glutamate

Answer 3

SV2A receptors

Question 4

what type of neurotransmitter is GABA?

Answer 4

inhibitory

Question 5

GABA is recycled and broken down by ___

Answer 5

transaminase

Question 6

seizure is cause by disfunction of GABA receptor and causes decreased ___ influx
_____ deficiency disorder in pediatrics

Answer 6

Will not respond or open for GABA,
Decreased anions [Cl- ] influx,
Remains in a constant depolarization state and positive action potential firing in the axon…..
GABA – transaminase deficiency disorder in pediatrics [epilepsy, uncontrolled limb movement, hyperreflexia, hypotonia and hypersomnolence

Question 7

what’s the definition of a seizure

Answer 7

A seizure is a sudden, transient disruption in brain electrical function caused by abnormal excessive discharges of cortical neurons, resulting in the occurrence of clinical signs and/or symptoms

Question 8

Epilepsy (chronic seizure) definition

Answer 8

(1) at least two unprovoked (or reflex) seizures occurring more than 24 hours apart;

(2) one unprovoked (or reflex) seizure and a probability of further seizures similar to the general recurrence risk (at least 60%) after two unprovoked seizures, occurring over the next 10 years;

(3) diagnosis of an epilepsy syndrome [most genetic paediatric presentations] West syndrome, Lenox Gestalt Syndrome, Jr. Myoclonic epilepsy”

Question 9

causes of seizure (VITaMIN CDEs)

Answer 9

vascular
infection
trauma
autoimmune
metabolic
idiopathic
neoplastic
congenital
drugs/dementia/demyelination
eclampsia
stress/stimulation/sleep deprived

Question 10

drugs causes seizure (OTIS CAMPBEL)

Answer 10

O = opioids [Meperidine and tramadol are strong triggers]
T = Tricyclic Antidepressants [amitriptyline, nortriptyline and anticholinergic drugs]
I = Isoniazid
S = Salicylic toxicity [too much ASA]
C = Cocaine/Cefepime [cephalosporins]
A = Amphetamines [Ritalin / Adderall]
M = Metronidazole MTZ antibiotic
P = Penicillin
B = BZD withdrawal, Bupropion [Wellbutrin®] NOTE: used anxiety and smoking cessation Zyban®
E = ETOH withdrawal
L = Lithium

Question 11

3 phases of seizure

Answer 11

Preictal phase
Ictus phase
Postictal phase

Question 12

Todd’s paralysis

Answer 12

focal seizure with impairment [unilateral body paralysis resolves over time]

Question 13

classifications of seizure types

Answer 13

focal onset
generalized onset
unknown onset

Question 14

what’s a focal seizure
sign/symptoms

Answer 14

Focal Seizure: abnormal electrical activity or firing, synchronous that remains in one cerebral hemisphere

Symptoms/signs often on contralateral size = the opposite side of the body from the effected firing hemisphere.

Question 15

6 types of focal motor seizure

Answer 15

1.atonic: sudden loss of muscle tone
2. tonic: stiffening of muscle tone
3. clonic: rhythmic jerking of muscle
4. myoclonic: fast jerking of muscle
5. Jacksonian March: from distal to proximal
6. motor vocal

Question 16

types of focal non-motor seizures

Answer 16

Primary somatosensory cortex
Primary auditory cortex
Primary visual cortex
Primary olfactory cortex
Primary gustatory cortex

Question 17

psychological/cognitive symptoms of focal seizrue

Answer 17

1. deja vu
2. derealization
3. depersonalization
4. emotional
5. cognitive: memory impairment

Question 18

which area is affected during focal seizure that causes autonomic symptoms?

Answer 18

posterior temporal lobe (insula area)

Question 19

what are the autonomic symptoms during a focal seizure?

Answer 19

tachycardia
hypertension
urinary incontinence
salivation
sweating

Question 20

what’s a focal seizure with impairment?

Answer 20

abnormal synchronous firing that starts in the one cerebral hemisphere but crosses the thalamus and reticular formation [brain stem = arousal/survival centre]

Question 21

LAP (focal seizure with impairment)

Answer 21

Loss of consciousness
Aura
Postictal anmesia/confusion

Question 22

what’s a mixed seizure

Answer 22

abnormal electrical activity or firing, synchronous that starts in one cerebral hemisphere moves cross the thalamus and reticulum formation and crosses the corpus callosum to involve the other cerebral hemisphere creating generalized seizures

Question 23

what’s generalized motor seizure?

Answer 23

Motor: includes the reticular formation & thalamus [always with impairment and a postictal state]

Question 24

what’s generalized non-motor seizure?

Answer 24

absence seizure

Question 25

types of generalized motor seizures

Answer 25

bilateral MSK motor
MSK of all systemic organs
Autonomic (crosses into brainstem)