Seizure and Epilepsy Flashcards

1
Q

What is epilepsy?

A

Recurring and spontaneous seizures affecting 1 in 100-200 people

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are primary generalizes onset seizures?

A

Electrical discharges appear to start over the whole brain at the same time without a warning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are secondary generalized seizures?

A

Electrical discharges start in one area and then either remain localised or spread over the whole brain. There is a warning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are idiopathic generalized seizures?

A

Onset is in childhood or adolescence
Usually no focal symptoms/signs
Polygenic cause
Provoked by sleep deprivation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is Juvenile myoclonic Epilepsy (JME)?

A

The most common form of generalised epilepsy

It has juvenile onset
Can be with or without absences
Photosensitive and triggered by sleep deprivation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are generalised tonic clonic seizures?

A

Sudden onset, without warning in primary generalised epilepsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the stages in a tonic, clonic seizure?

A

Tonic phase: continuous muscles spasm, fall, cyanosis, tongue biting, incontinence

Clonic phase: Rhythmic jerking slows and gets larger in amplitude as attack ends (lasts 1-3 minutes)

Post-ictal stage: Coma, drowsiness, confusion, headache, muscle aching, memory loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is a grand mal seizure also known as?

A

A generalised tonic clonic seizure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is a petite mal?

A

An absence lasting 5-20 seconds

It happens multiple times a day
Tone is preserved
Person is unresponsive and looses memory for that interval

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is a simple partial seizure?

A

The patient is aware because there is an aura

Now called a focal seizure with awareness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a complex partial seizure?

A

An aura with a level of reduced awareness

Now called a focal seizure with reduced awareness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Where do partial seizures most commonly occur?

A

In the temporal lobe (70%) and frontal (25%)`

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why are deep sited seizures often missed?

A

Because the EEG measures extracellular activity and it’s hard with a deep seizure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are some causes of temporal lobe seizures?

A
Hippocampal sclerosis (50%)
Tumour (18%)
Birth hypoxia (10%)
Post traumatic (8%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some signs and symptoms of temporal lobe epilepsy?

A
  • Hallucinations of taste, speech and smell
  • Pallor, flushing, heart rate changes
  • Automatisms likes semi-purposeful limb movements and lip smacking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are some signs and symptoms of a frontal lobe seizure?

A

Forced head
Eye deviation to the contralateral side
Jacksonian spread with Todd’s paresis

17
Q

What is a Jacksonian March?

A

A type of focal partial seizure

18
Q

What is Todd’s paresis

A

A paralysis that follows a seizure

19
Q

What are some symptoms of parietal lobe seizures?

A

Positive sensory symptoms
Tingling/pain
Distortion of body shape/image
Jacksonian march

20
Q

What are some symptoms of occipital lobe seizures?

A
  • Typically simple visual hallucination like calls of coloured or flashing lights
  • Amaurosis (blackout or whiteout) at onset
21
Q

What is the difference between a blackout and a whiteout?

A

Blackout- loss of memory

Whiteout- fainting

22
Q

What is the definition of epileptogenesis?

A

The process by which parts of a normal brain are converted into hyperexcitable brain

23
Q

Which channelopathies are associated with epilepsy?

A
  • Na+ channel inactivation is too slow in excitatory neurones. Caused by a Na+ channel mutation and causes impaired action potential repolarization
  • Reduced number of functional Na+ channels in inhibitory neurones. Causes impaired action potential generation
  • Reduced number of K+ channels in excitatory neurones. Causes impaired action potential repolarisation
24
Q

What do anti-epileptic drugs (AED’s) do?

A

They prevent the spread of a seizure of epileptic discharges so that the seizure is more controlled

They don’t prevent seizures

25
How does the drug Perampanel work?
It's a non-competitive inhibitor of AMPA glutamate receptors. Release of glutamate cannot overcome the block It reduces spread of seizure but can also affect mood and behaviour
26
How does the drug Levetiracetam work?
It's a high affinity synaptic vesicle protein-2A ligand that helps modulate glutamate neurotransmitter release It can cause low mood and agitation. It has no drug interactions
27
Which drugs are first line treatments for primary generalized epilepsy?
Sodium Valproate or Lamotrigine
28
Which drugs are first line treatments for partial focal onset epilepsy?
Carbamazepine or Lamotrigine
29
Which anti-epileptic drugs exacerbate generalised seizures like myoclonus or absences?
Phenytoin Carbamazepine Gabapentin/Pregabalin
30
What are some symptoms of using benzodiazepines for epilepsy?
Dose related: Drowsiness, ataxia, hyperactivity, cognitive impairment Long term: Tolerance/ Dependence
31
What are some symptoms of using Phenytoin for epilepsy?
Dose related: Ataxia, Diplopia, Nystagmus Long term: Gingival hyperplasia, Osteomalacia, Cerebellar atrophy
32
What are some symptoms of using Sodium Valproate for epilepsy?
Dose related: Sedation, Tremor Long term: Hair thinning, weight gain, menstrual irregularities, encephalopathy, Parkinsonism
33
What is the teratogenicity of Sodium Valproate?
30% impaired cognitive development Reduced infant IQ Higher rate of congenital malformations More common in mothers with intellectual disability