W5_05 Epilepsy Surgery Flashcards

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1
Q

focal seizures from which part of the brain have a better chance of a surgical cure?

A

temporal

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2
Q

what proportion of people get surgery for epilepsy each year?

A

about 2%

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3
Q

how long does it take to get surgery for epilepsy, from the time of the first seizure?

A

22 years

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4
Q

the hippocampus takes afferents from what?

A
cerebral cortex;
septal area;
contralateral hippo.;
nuclei in reticular formation;
subcortical afferents
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5
Q

amygdala gets afferents from what?

A

olfactory;

hypothalamus

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6
Q

amygdala sends efferents to what?

A

dorsal nucleus of vagus;

nucleus solitarius

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7
Q

name some auras of temporal lobe epilepsy

A
deja vu (affecting hippo);
nasty smell (affecting uncus/amygdala);
fear and anxiety (affecting amygdala);
autonomic nuclei
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8
Q

what happens in seizures of TLE?

A
blank stare;
automatic behaviour;
orofacial twitching;
speech arrest;
wandering;
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9
Q

what happens in post-ictal phase of TLE seizures?

A
disoriented;
tired;
headache;
psychotic;
depressed LoC if progression to generalized seizure
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10
Q

what is the most frequent lesion associated with medical refractory TLE?

A

mesial temporal sclerosis;

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11
Q

loss of neurons in CA1, CA4, and dentate gyrus is a characteristic of what?

A

mesial temporal sclerosis

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12
Q

the dominant side of temporal lobe is responsible for what?

A

verbal memory

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13
Q

the non-dominant side of temporal lobe is responsible for what?

A

visual/spatial memory

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14
Q

what is the wada test used for?

A

determine dominance via language hemisphere selection (intracarotid amytal test)

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15
Q

what is the eSAM test for?

A

etomidate speech and memory test

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16
Q

risk to memory is highest when surgery is done on which side?

A

it’s especially risky on the side that’s dominant for speech

17
Q

risks of surgery?

A
risk to language;
visual field cuts;
stroke;
infection;
hemorrhage
18
Q

what’s the success rate of surgery for TLE patients?

A

over 80% are seizure free