seizure epilepsy Flashcards

1
Q

differences between seizures & epilepsy?

A

seizure - one occurrence

epilepsy - chronic occurrences of seizures

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2
Q

what is a seizure?

A

period where a group of neurons in brains are synchronously firing, when they should not be.

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3
Q

cause of a seizure?

why does this happen basically?

A

sudden excitatory signals happening over and over again

↑excitatory neurotransmitter or ↓inhibitory neurotransmitters

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4
Q

what is the main excitatory neurotransmitter?

what receptor does it hit?

A

glutamate

hitting NMDA receptors

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5
Q

what is the main inhibitory neurotransmitter?

what receptor does it hit?

A

GABA

hitting on GABA receptors

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6
Q

what is the main excitatory neurotransmitter?

what receptor does it hit?

when this excitatory neurotransmitter hits this receptor, what happens?

A

glutamate

NMDA receptor

Ca2+ influx –> AP generated

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7
Q

what is the main inhibitory neurotransmitter?

what receptor does it hit?

when this inhibitory neurotransmitter hits this receptor, what happens?

A

GABA

GABA receptors

Cl- influx –> AP inhibited

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8
Q

how are seizures categorised/ defined?

-4 ways

A

is it local or general

which lobe effected

by level of consciousness

based on symptoms

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9
Q

1 hemisphere or 1 lobe having a seizure,

what is this called?
-2 name

if he is conscious, what is it called then?
-2 names

if he has impaired consciousness, what is it called then?

A

focal aka partial

aware or simple

focal impaired awareness

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10
Q

Both hemispheres having a seizure,

what is this called?

A

generalised seizures

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11
Q

define tonic seizures?

what might happen to pt, especially scary in older people?

A

muscle stiffen & flex

pt falls backwards

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12
Q

define atonic seizures?

A

muscles floppy

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13
Q

what might happen to pt, especially scary in older people?

A

pt falls forward

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14
Q

person has seizure with violent muscle contractions.

what kind of seizure is this?

A

Clonic

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15
Q

define tonic-clonic seizures?

A

= muscles tense & then rapidly relax & contract

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16
Q

define myoclonic seizures?

A

short muscle twitches

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17
Q

what is the most common type of seizure based on symptoms?

A

Tonic-clonic

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18
Q

person has seizure where they lost consciousness but then quickly regained consciousness, looks like they spaced out.

what seizure was this?

A

Absence seizures

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19
Q

pt has focal to bilateral hemisphere seizure.

what is this seizure called?

A

secondary generalised seizures

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20
Q

define status epilepticus ?

what type of seizure is this normally based on symptoms?

A

Seizures ≥ 5 minutes

tonic-clonic

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21
Q

status epilepticus is not an emergency.

true or false?

A

false

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22
Q

drug class to treat status epilepticus?

A

benzodiazepines

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23
Q

Epilepsy Prevalence in the UK? %

A

0.8%

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24
Q

RF for epilepsy?

-3

A

Cerebral palsy – 30% have epilepsy
Tuberous sclerosis
Mitochondrial disease

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25
mostly epilepsy just happens, whether there are RF or not. true or false?
true
26
pt has 1 lobe or hemisphere having a seizure. if he is conscious, what is this type of seizure called? -2 names if he has impaired consciousness, what is it called then? -2 names
focal aware or simple partial focal impaired or complex partial
27
age group and gender that has most absence seizure?
3-10year olds | girls
28
prognosis for absence seizures?
90-95% grow out of it in adolescence
29
1st line Mx for absence seizures? | -2 drugs
Sodium valproate & ethosuximide
30
how does syncope differ from epilepsy? (i. e. what features does syncope have that epilepsy does not). - 4
syncope: nausea darkened vision muffled ears beforehand, gradually lose consciousness
31
driving rules for someone who just had a seizure?
no driving 6 months
32
driving rules for someone who was just diagnosed an epileptic?
must be seizure-free 12 months to drive again
33
Antiepileptic meds inhibit what anticoagulant med?
warfarin
34
Antiepileptics are contraindicated in pregnancy. why? which antiepileptics is particularly problematic in pregnancy?
they are teratogenic sodium valproate
35
drug group used to target epilepsy? | - has two names
Antiepileptic aka anticonvulsant
36
1st line long term Mx for focal seizures? -name drug group of this drug? this drug can however actually exacerbate two types of seizures, which ones?
carbamazepine Antiepileptic aka anticonvulsant absence & myoclonic seizures.
37
1st line long term Mx for general seizures? -name drug group of this drug?
sodium valproate Antiepileptic/anticonvulsant
38
define general seizures?
Both hemispheres having seizure
39
what is the postictal phase ?
feel drowsy for ~15 min post seizure
40
genera symptoms of seizures?
Altered levels of consciousness Muscle tightening/floppiness/contraction etc. Bite tongue Incontinence of urine Postictal phase
41
Symptoms of a focal seizure depend on locality. what is the differentiating symptom if seizure is in frontal lobe parietal lobe occipital lobe (3) temporal lobe (2)
frontal lobe – head/leg movement, posture is weak parietal lobe- paraesthesia occipital lobe – floaters/flashes/colours (visual) temporal lobe – hallucinations, lip smacking
42
which Ix is used to record brain activity?
Electroencephalogram
43
person is having a seizure, it has only been a couple of minutes. what is the 1st line acute Mx here?
1st: ABCDE + recovery position
44
person is having a seizure, it has been 5 minutes. what drug can you give to help stop seizure? - class - routes
Benzodiazepine intranasally under tongue
45
person is having a seizure, it's been over 10 minutes. what is this seizure called now?
status epilepticus
46
child is having a seizure, what medication is 1st line to stope seizure acutely here. - name - preferred route
diazepam rectal
47
what are the two main drugs used to prevent seizures? moa of each?
Sodium valproate - ↑GABA Carbamazepine - blocks Na+ channels
48
moa of BZD? | -step by step
↑GABAA --> ↑Cl- influx --> causes rapid hyperpolarisation and ∴ neuronal inhibition
49
child has myoclonic seizure in morning after poor sleep. what seizure is this?
juvenile myoclonic epilepsy
50
juvenile myoclonic epilepsy age of onset
12
51
sex most effected by juvenile myoclonic epilepsy?
females
52
best drug to stops symptoms of juvenile myoclonic epilepsy?
sodium valproate
53
juvenile myoclonic epilepsy is an umbrella term, what three seizures come under it which the pt will experience?
myoclonic tonic-clonic absence
54
why should you be careful of using sodium valproate in female teenage with juvenile myoclonic epilepsy?
malformations in pregnancy
55
pt has juvenile myoclonic epilepsy, what do you see in EEG?
3-6Hz spikes
56
# define epileptic seizure define non-epileptic seizures
abnormal electrical discharge in the brain no abnormal electrical discharge
57
non-epileptic seizures aka?
pseudoseizure
58
how can prolactin be used to differentiate between epileptic seizures and non-epileptic seizures?
Prolactin goes up in epileptic seizures but not pseudoseizures
59
how can tongue biting be used to differentiate between epileptic seizures and non-epileptic seizures?
epileptic = bite sides of tongue | pseudo epileptic = bite tip of tongue.
60
Non - Epileptic seizure causes
mental stress diabetes sleep arrhtymia
61
features of non - epileptic seizures that make it differ from epileptic seizures? - 4 - (in terms of symptoms)
Eyes closed Alert through event No post ictal phase Will not respond to AED’s
62
CNS triggers of seizures? | -6
``` Strokes Haemorrhage in brain Cortex is malformed Hippocampus is sclerosed Trauma to brain Infection ```
63
what electrolyte imbalances can cause triggers seizure? | -3
hyponatraemia, hypocalcaemia, hypomagnesemia
64
PNS triggers of seizures? | -6
``` Electrolyte imbalance – hyponatraemia, hypocalcaemia, hypomagnesemia Drugs – cocaine Alcohol withdrawal – super common! Hypoglycaemia Arrhythmia ```