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Neurobiology > Seizures and Epilepsy > Flashcards

Seizures and Epilepsy Flashcards

1
Q

what is a seizure?

A

clinical manifestation of excessive hypersynchronous neuronal activity

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2
Q

what does it mean that a seizure is a paraxysmal event?

A

sudden and transient

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3
Q

what are seizures characterized by?

A

motor, autonomic, and behavioral manifestations

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4
Q

how long does a seizure last?

A

brief: 1-3 minutes

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5
Q

where do seizures usually come from in the brain?

A

prosencephalon/forebrain

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6
Q

in the normal state, there is a balance between _______________ and ________________

A

neuroexcitation
neuroinhibition

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7
Q

what structural changes occur with seizure propagation?

A

loss of lateral and surrounding inhibition
outgrowth of aberrant excitatory axons
loss of inhibitory neurons
denervation hypersensitivity

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8
Q

what molecular changes occur with seizure propagation?

A

increase in number, sensitivity, and distribution of glutamate receptors
decreased GABA receptor expression
decreased GABA production
reduced potassium and glutamate uptake

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9
Q

what electrical charges occur with seizure propagation?

A

paroxysmal depolarizing shift: abnormal fluctuations of neuronal membrane voltage, far outlast depolarization of normal action potentials

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10
Q

what is the seizure threshold?

A

level of neuronal inhibition that, when exceeded, results in uncontrolled discharge of the neurons

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11
Q

what happens in seizure propagation?

A

seizure focus
synchronous paroxysmal discharges in large area
kindling effect

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12
Q

what are the phases of an epileptic seizure?

A

prodrome
ictus
postictal

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13
Q

what is the prodrome/preictal phase of an epileptic seizure?

A

change in disposition before seizure

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14
Q

what is the ictus phase of an epileptic seizure?

A

seizure itself

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15
Q

what often occurs during the postictal phase of an epileptic seizure?

A

disorientation
apparent blindness
ataxia

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16
Q

what causes a focal epileptic seizure?

A

abnormal activity from localized group of neurons or network within one hemisphere

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17
Q

what signs are associated with focal epileptic seizures?

A

lateralized and/or regional signs

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18
Q

what motor signs are associated with focal epileptic seizures?

A

facial twitches

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19
Q

what autonomic signs are associated with focal epileptic seizures?

A

parasympathetic: hypersalivation, dilated pupils

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20
Q

where do generalized epileptic seizures originate from?

A

both sides of cerebral hemisphere

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21
Q

what is a tonic only generalized epileptic seizure?

A

sustained increase in muscle contraction

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22
Q

what is a clonic only generalized epileptic seizure?

A

excessive abnormal muscle contractions, typically bilateral

23
Q

what is the most common seizure type in dogs?

A

focal epileptic seizure evolving to become generalized

24
Q

does differentiating between focal and generalized epileptic seizures dictate treatment or severity of seizure disorder?

A

no

25
Q

what is status epileepticus?

A

seizure activity lasting more than 5 minutes

26
Q

why is it important to recognize cluster seizures and status epilepticus?

A

both are medical emergencies and hospitalization is recommended

27
Q

what does ATP depletion due to metabolic rate increasing during a seizure lead to?

A

cytotoxic edema

28
Q

what leads to neuronal necrosis during a seizure?

A

neuronal death by excitotoxicity
increase in intracranial pressure
metabolic rate increasing

29
Q

what are the effects of seizures systematically?

A

hyperthermia (heat stroke)
metabolic acidosis (elevated lactate)
noncardiogenic pulmonary edema

30
Q

what is epilepsy?

A

disease of brain characterized by an enduring predisposition to generate epileptic seizures

31
Q

how many seizures does an animal need to have to be considered epileptic?

A

at least two unprovoked
more than 24 hours apart

32
Q

what is a reactive/provoked seizure usually from?

A

extracranial or problem outside brain
natural response in brain to a transient disturbance in function

33
Q

are reactive/provoked seizures reversible?

A

yes, when cause of disturbance is corrected

34
Q

what therapeutic agent can cause reactive/provoked seizures?

A

ivermectin

35
Q

what household items can cause reactive/provoked seizures?

A

caffeine/chocolate
xylitol

36
Q

what is a heavy metal that can cause reactive/provoked seizures?

A

lead

37
Q

what is structural epilepsy from?

A

intracranial problem
provoked by intracranial/cerebral pathology

38
Q

what do you commonly see with structural epilepsy?

A

inter-ictal neurologic signs or exam abnormalities

39
Q

what does structural epilepsy require to confirm?

A

diagnostic imaging
cerebrospinal fluid analysis

40
Q

what is idiopathic epilepsy?

A

no demonstrable systemic or brain pathology: rule out diagnosis
first seizure between 6 months and 6 years

41
Q

what does status epilepticus double the risk of?

A

structural brain disorder or reactive seizures

42
Q

what are some important things to gather during a history?

A

triggering factors
duration of ictal phase
number and frequency of events
concurrent disorders
possible toxin exposure
diet history

43
Q

what are some things to pay special attention to during the neurologic exam?

A

signs of forebrain dysfunction
lateralizing signs
postictal changes and medications may influence neurologic exam

44
Q

what age group is more likely to have a structural cause?

A

more than 5 years of age

45
Q

when is a full workup recommended?

A

abnormal interictal neurologic exam
less than 1 year or more than 5 years at onset of seizure
cats
breeds with high prevalence of structural disease
status epilepticus, cluster seizures

46
Q

what is the goal in the hospital with seizures?

A

stop seizure
minimize excitotoxicity
avoid complications

47
Q

when should you start maintenance drugs for seizures?

A

status epilepticus
cluster seizures
two or more seizure events within a 6-month period

48
Q

what rodenticide can cause seizures?

A

bromethalin

49
Q

what is more likely if seizures are diagnosed in an animal less than a year of age?

A

metabolic or structural cause

50
Q

what are the add on seizure medications?

A

levetiracetam
zonisamide
felbamate
gabapentin
pregabalin
topiramate
telmisartan

51
Q

what are some toxins that can cause seizures?

A

ivermectin
caffeine/chocolate
xylitol
lead
bromethalin
ethylene glycol

52
Q

how common is idiopathic/cryptogenic epilepsy?

A

20%

53
Q

what are the first order medications?

A

phenobarbital
potassium bromide

Neurobiology (28 decks)

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