W5_05 Epilepsy Surgery Flashcards
focal seizures from which part of the brain have a better chance of a surgical cure?
temporal
what proportion of people get surgery for epilepsy each year?
about 2%
how long does it take to get surgery for epilepsy, from the time of the first seizure?
22 years
the hippocampus takes afferents from what?
cerebral cortex; septal area; contralateral hippo.; nuclei in reticular formation; subcortical afferents
amygdala gets afferents from what?
olfactory;
hypothalamus
amygdala sends efferents to what?
dorsal nucleus of vagus;
nucleus solitarius
name some auras of temporal lobe epilepsy
deja vu (affecting hippo); nasty smell (affecting uncus/amygdala); fear and anxiety (affecting amygdala); autonomic nuclei
what happens in seizures of TLE?
blank stare; automatic behaviour; orofacial twitching; speech arrest; wandering;
what happens in post-ictal phase of TLE seizures?
disoriented; tired; headache; psychotic; depressed LoC if progression to generalized seizure
what is the most frequent lesion associated with medical refractory TLE?
mesial temporal sclerosis;
loss of neurons in CA1, CA4, and dentate gyrus is a characteristic of what?
mesial temporal sclerosis
the dominant side of temporal lobe is responsible for what?
verbal memory
the non-dominant side of temporal lobe is responsible for what?
visual/spatial memory
what is the wada test used for?
determine dominance via language hemisphere selection (intracarotid amytal test)
what is the eSAM test for?
etomidate speech and memory test