T3 Epilepsy

Question 1

definition of seizure

Answer 1

occurrence of at least 2 unprovoked seizures with or with convulsions separated by at least 24 hours. convulsion is violent / involuntary contractions of voluntary muscle.

Question 2

general pathophysiology of epilepsy

Answer 2

1. Influx of sodium
2. influx of calcium
3. release of glutamate
4. activation of excitatory (glutamate) receptor (NMDA and non-NMDA - AMPA & KA) cause neuronal firing
5. reduction of gaba inhibitor

Question 3

action of glutamate if bind to NMDA or non NMDA receptor

Answer 3

if bind to NMDA, longer action but slow excitatory post synaptic potential

if bind to non NMDA, FAST excitatory

Question 4

______ and ______ must bind to the NMDA receptor in order for it to open

Answer 4

glutamate and glycine

Question 5

seizure happens due to __________ of excitatory and inhibitory transmitter

Answer 5

imbalance

Question 6

causes of seizures in newborn

Answer 6

brain malformation
maternal drug use
lack of brain oxygen during birth
intercranial hemorrhage
inborn error in metablokism
low levels of glucose and cations

Question 7

cause of seizure in infant and young child

Answer 7

febrile seizure
brain tumor (rare)
infection

Question 8

cause of seizure in adult or child

Answer 8

genetic
head trauma
congenital condition (down syndrome, angelman’s syndrome, tuberous sclerosis & neurofibromatosis)
progressive brain disease (rare)

Question 9

classification of seizure

Answer 9

partial seizure
generalized seizure
status epilepticus
unclassified seizure

Question 10

other name of partial seizure

Answer 10

focal

Question 11

class of partial seizure

Answer 11

3 class:

simple
complex
secondary generalized

Question 12

difference between partial and generalized seizure

Answer 12

partial happens w local onset, genralized occurs without local onset happens bilaterally symmetrical

Question 13

difference between simple and complex partial seizure

Answer 13

simple still concius, complex not concious

Question 14

type of seizure under generalized siezure (7)

Answer 14

absence
myoclonic
clonic
tonic
tonic-clonic
atonic
infantile spasm

Question 15

simple partial sizure comes with 3 type of symptoms

Answer 15

motor symptoms
sensory symptoms
psychic symptoms

Question 16

complex partial seizure can happen with or without ______

Answer 16

automatisms

Question 17

symptoms of partial seizure

Answer 17

1. motor: muscle jerking and stiffening, lip smacking, chewing
2. sensory: unusual sensation (aura), paresthesia
3. automatism: sweating, pupil dilation, flushing, falling
4. behaviour: loss of consciousness, hallucination and dysphasia (slurred speech)

Question 18

symptoms of abssence seizure

Answer 18

blank stare
brief upward rolling of the eye
interruption of current activity

Question 19

absence seizure is also known as

Answer 19

petit mal

Question 20

absence seizure last for

Answer 20

less than 15 seconds

Question 21

tonic clonic is also known as

Answer 21

grand mal

Question 22

tonic-clonic seizure begins with what phase

Answer 22

begins with tonic phase then clonic

Question 23

explain tonic-clonic seizures

Answer 23

the first phase is tonic phase. patient will become rigid abd fall on the ground with back ache for 1 mins. the respiration will be interrupted.

second phase is clonic phase. patient will experience rapid muscle jerking and muscle flaccidity. patient will suffer incontinence, tongue biting and heavy salvation.

Question 24

clinical presentation of tonic-clonic seizure

Answer 24

cyanotic due to respiratory interrupted
rapid muscle jerking
muscle flaciddity
back ache
body rigid
incontinence
tongue biting
heavy salvation
deep sleep

Question 25

difference between clonic anf myoclonic

Answer 25

mycolonic is shock like muscle contraction
clonic is muscle jerking

Question 26

what is the diagnostic test of seizure

Answer 26

check the prolactin level after 10-20 mins
why? bcs to differentiate pseudo seizure

others:
lab test SMA 20
CBC
urinalysis
special bond chemisteries
lumbar puncture (if fever)
MRI
EEG
neurological imaging (MRI, functional MRI, PET, SPECT)

Question 27

why diagnostic test is conducted

Answer 27

to rule out treatable cause of seizure

Question 28

5 mechanism of AED

Answer 28

enhancement of gaba action
inhibition of sodium channel fx
inhibition of calcium channel fx
block of glutamate receptor
inhibit glutamate release