Sleep/Epilepsy Flashcards
0
Q
ARAS
A
- thalamic connections: cholinergic
- cortical connections: monoaminergic
- responsible for coordination of atonia and sleep cycles
1
Q
Wave sleep
A
- nonREM (1,2)
- deep sleep (slow wave sleep) - K complexes appear in stage 2: 3-4
~ REM: high brain activity, looks like more like wakefullness
2
Q
ARAS lesion: cause presentation
A
- Lewy body dementia
- Parkinson’s
- loss of muscle atonia -> injury
3
Q
REM generators
A
- In SLD and PC nuclei in pons
- ascending: dreaming
- descending: muscle atonia
- REM off neurons are GABA
4
Q
Orexin neurons
A
- modulate ARAS to control sleep wake transitions
- damage = narcolepsy
5
Q
Narcolepsy
A
Cataplexy: (narcolepsy only) weakness triggered by laughter or excessive emotion
- hypnagogic hallucinations: dreams at sleep onset
- sleep paralysis
6
Q
Seizure basics
A
- rhythmic excitations; Normal rhythms abnormally recruited
- Maybe simple complex or secondary; bi or uni
~ simple: consciousness not impaired
~ complex: consciousness impaired
~ secondary: imp. Conc. + additional motor sequence
7
Q
Childhood epilepsy
A
- 6 y/o peak onset/occurrence
- frequent, brief (milliseconds-seconds)
- no post ictal confusion
8
Q
Temporal lobe epilepsy: etiology and presentation
A
- most common: type of partial
- damaged hippocampus
- auras in 90%
- unilateral typically involves motor
- frequently intractable
- often accompanied by strange experimental symptoms
9
Q
West syndrome: presentation
A
- infantile spasms, frequent, brief tonic flexor/extensor spasms
- developmental regression
- EEG hypsarrythmia
- associated with development of cog disability
- trt with topiramate/vigabatrin
10
Q
Psychogenic seizures
A
- non epileptic (not faking)
- EEG + video to diagnose
11
Q
Febrile seizures
A
- no brain infxn
- results from rapid fever spike
- usually longer, but self limiting
- focal onset with recurrence w/in 24 hrs -> increased risk of dev epilepsy
12
Q
Status Epilepticus
A
- sustained, after 20-30 minutes may become pharm resistant
- trt: most stop seizure. IV/rectal benzos (diazepam/lorazepam)
- hypoxia, acidosis, rhabdo, hypotension, hyperarrythmias
13
Q
Absence seizures
A
- trt with Ca channel blockers: valproic acid, lam, ethosuximide, Clonazepam
- triggered by hyperventilation
- brief, frequent, no post ictal confusion
- assoc with GTC at least once 30% of the time
14
Q
Frontal lobe hypermotor seizures
A
- occurs in sleep
- lots of motor involvement
- impaired consciousness/PI confusion
