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Neuroscience > Seizure Disorders > Flashcards

Seizure Disorders Flashcards

1
Q

Seizure

A

. Stereotyped episode involving altered sensory, motor, ANS function, and consciousness
. Location and spread in brain determines how it presents
. Due to abnormal and excessive electrical discharges w/in brain
. Diagnosed based on behavioral evidence and EEG

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2
Q

Epilepsy

A

. Spontaneous recurrent seizures with no cause

. Usually can lead normal lives, but 38% suffer sudden unexpected death in epilepsy (SUDEP)

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3
Q

Partial (focal) seizures

A

. Begin in restricted brain region and remain localized or spread to djacent cortical areas
. Most common form

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4
Q

Simple partial seizures

A

. No loss of consciousness
. Abnormal electrical activity localized
. Presentation shows brain region involved
. EEG will appear normal w/ abnormal activity recorded in 1 or 2 areas

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5
Q

Complex partial seizure

A

. Loss of consciousness
. Abnormal electrical activity localized
. Simple motor activities done during seizure
. Upon recovery patient is not always aware they were doing a specific action
. May be preceded by aura
. Temporal lobe/psychomotor seizures under of nomenclature
. EEG shows focal spikes in temporal lobe areas

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6
Q

Partial seizures w/ secondary generalization

A

. Loss of consciousness
. Abnormal electrical activity spreads from seizure focus
. Intense motor activity
. Can progress to most or all of the brain
. In this case patient losses consciousness and has convulsions

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7
Q

Generalized seizures

A

. Involves entire cortex

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8
Q

Absence seizures

A

. Loss of consciousness
. A Rona last electrical activity through brain
. No convulsions or loss of postural control
. Sudden brief lapses
. Usually diagnosed in school age kids
. Used to be called petit-mal
. EEG shows spike and dome shapes at freq. of 3-4 per second (characterize abnormal synchrony)
. All pairs of electrodes record abnormal activity

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9
Q

Generalized tonic-clinic seizures

A

. Grand-mal
. Loss of consciousness suddenly
. Abnormal electrical activity through entire brain
. Tonic and clonic phases
. Toncis phase: contraction of mm. Including expiratory mm. Accompanied by cry
. May become cyanotic
. Clonic phase: limbs move rhythmically and person can breathe again
. Person may attempt to swallow tongue
. Gradual return to consciousness after that
. EEG shows excessive neuronal discharge in cortex and even spinal cord w/ hug spikes at very high frequency

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10
Q

Status epilepticus

A

. Situation when a type of seizure inc on tiny outs and there is no period of recovery period the next one
. Serious condition and can be life-threatening in tonic-clonic seizures

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11
Q

Cause of epilepsy

A 
. 62% unknown 
. Stroke and head trauma 
. Alcohol 
. Neurodegenerative disease 
. Static encephalopathy 
. Brain tumors 
. Infection
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12
Q

Drug types that can cause seizures when high doses given over long periods of time

A

. CNs stimulates (amphetamines and analeptics)
. Cardia antiarrhythmic drugs (lidocaine)
. Drugs used to treat bipolar (Li)
. Antibiotics (penicillin)

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13
Q

Age groups seizures are more common in

A

Infants and adults over 60

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14
Q

Causes of seizure in newborns

A 
. Congenital malformation 
. Perinatal hypoxia/ischemia
. Trauma (intracranial birth injury)
. Metabolic disturbance (hyperglycemia, hypoatremia, etc)
. Genetic 
. Intracranial hemorrhage 
. Maternal drug use
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15
Q

Seizure causes for children

A

. Fever
. Acute infection
. Brain tumors
. Can also occur in infants

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16
Q

Causes of seizure in both children and adults

A

. Congenital condition (downs, angelman’s, tuberous sclerosis, neurofibromatosis)
. Genetic
. Head trauma
. Progressive brain disease

17
Q

Seizure causes in seniors

A

. Stroke
. Metabolic disorders
. Alzheimer’s
. Head trauma

18
Q

Penicillin cause for causing seizures

A

. High doses block GABA action

19
Q

2 primary excitatory NTs

A

. Glu

. Aspartate

20
Q

Benzos and barbiturates effect in neurotransmitters

A

. Binding of drugs to GABAa receptor (Cl channel) enhances effect of GABA on opening channel
. Explains widespread inhibitory effects of these drugs
. May be of some use in preventing seizures
. Benzos bind to gamma subunit of channel
. Barbiturates bind to beta subunit of channel

21
Q

Strychnine

A

. Poisonous plant
. Blocks inhibitory action of Gly in spinal cord
. Produces tonic mm. Spasms that can cause asphyxiation from tonic contraction of respiratory mm.
. Muscle spasms result of disinhibited spinal reflexes
. Not considered true seizure of cerebral origin since it is from spinal cord

22
Q

Treatment goals of epilepsy

A

. Prevent or reduce excessive firing from damaged or abnormal neural tissue
. Prevent or reduce spread of excessive firing to normal neural tissue
. Most drugs target the spreading portion of goal

23
Q

Monotherapy vs polytherapy in epileptic treatment

A

. 70% patients become seizure free w/ single drug
. Many of polytherapy w/ 2nd generation or taking 3 meds w/ a 3rd generation med
. Some patients develop drug-resistant seizures (refractory epilepsy)
. Narrow spectrum drugs only good for focal seizure
. Broad spectrum drugs used in adults no matter what type fo seizure

24
Q

Traditional anticonvulsants

A 
. Benzos
. Phenobarbital
. Phenytoin
. Carbamazepine
. Valproate 
. Act by potentiating effects of GABA by enhancing Cl channel opening or by inhibiting GABA reuptake
25
Q

benzo antagonists

A

. Prevent GABA enhancement but do not reduce basal Cl current
. Prevent gating of Cl channels even in presence of benzos

26
Q

Other drugs that inhibit GABA

A

. Vigabatrin: inhibit GABA degradation
. Tiagabine: inhibit GABA reuptake
. Gabapentin: unclear on how it works though

27
Q

What do newer antiepileptic drugs target?

A

. excitatory AAs (NMDA, AMPA, and kainate classes of Glu receptors)
. Offer fewer drug interactions, unique methods of action, and broad spectrum activity
. Voltage-dependent ion channel blockage, enhancement of neurotransmission, and reduction of excitatory NTs

28
Q

Surgery for seizures

A

. Useful treatment for seizures from tumors and localized epileptic sources
. Severing corpus callosum as last resort for seizure patients

29
Q

Vagus n. Stimulation as seizure treatment

A

. Used for patients w/ recurring partial seizures and have been unresponsive to meds
. Works by electrically stimulating vagus n. In neck
. Stimulates inhibitory parts of brain
. Long-term effectiveness still needs to be determined

30
Q

Ketogenic diet as seizure treatment

A

. Has anticonvulsant effects similat to that of starvation

. More useful for children

31
Q

Medical weed as seizure treatment

A

. CBD could be useful for seizures

. Currently sued to treat 2 rare childhood epilepsy syndromes

Neuroscience (31 decks)

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