Week 7 H14,15,16,23

Question 1

Match the given Clinical criteria with the appropriate descriptions:

1Epileptic seizure
2Epilepsy
3Epilepsy syndrome
a. Continuous epileptic activity on the EEG even if seizures are not observable.
b. Occurrence of at least two unprovoked (or reflex) seizures with an interval between seizures of more than 24 hours.
c. Diagnosis based on a combination of seizures, EEG findings, and often associated with cognitive, emotional, and/or psychosocial problems in some patients.

Answer 1

1-b, 2-a, 3-c

Question 2

Name the three types of Seizure type.

What are the four classifications under Epilepsy type?

Answer 2

Question 3

Which Seizure type leads to a Generalized Epilepsy type?

Answer 3

Generalized.

Question 4

How does a Focal seizure with awareness differ from one without awareness?

Answer 4

A Focal seizure with awareness allows patients to interact with their surroundings, while one without awareness can lead to automating or stereotypical action and an absent-mindedness.

Question 5

What characterizes a seizure with a generalized onset or primary generalized seizure?

Answer 5

It occurs due to epileptic discharges in both hemispheres of the brain simultaneously, leading to a loss of consciousness.

Question 6

What is the difference between a tonic and a clonic seizure?

Answer 6

Tonic seizures involve body stiffness,

while clonic seizures involve a combination of stiffening and jerking.

Question 7

How can you identify a status epilepticus?

Answer 7

It’s when an epileptic seizure does not resolve after a few seconds or minutes as usual.

Question 8

What is the difference between convulsive status epilepticus and non-convulsive status epilepticus?

Answer 8

Convulsive involves continuous muscle twitching or cramps, while non-convulsive does not involve these symptoms.

Question 9

What does an epilepsy syndrome refer to?

Answer 9

It refers to a distinctive cluster of disease characteristics.

Question 10

What condition is characterized by an abnormal way in which neurons in the cerebral cortex are developed and organized?

Answer 10

Cortical dysplasia

Question 11

What is the main goal of the medication used in the treatment of epilepsy?

Answer 11

It doesn’t treat the cause but diminishes the electrical excitation in the brain that would lead to an epileptic seizure.

Question 12

What does refractory mean in the context of epilepsy?

Answer 12

Refractory refers to cases where epilepsy is difficult to treat, preventing the achievement of seizure freedom with medication.

Question 13

What does the second hypothesis suggest about the type of epilepsy and cognitive impairment?

Answer 13

It suggests the pathophysiology of the type of epilepsy is predictive for cognitive impairment.

Question 14

Which factor plays a significant role in predicting cognitive (dys)function?
a. Number of seizures
b. Age of the patient
c. Efficiency of brain networks
d. Type of medication

Answer 14

c

Question 15

What cognitive function is mainly associated with Temporal lobe epilepsy?

Answer 15

Memory, especially impairments in episodic memory.

Question 16

Why is autobiographical memory special in epilepsy patients?

Answer 16

They report more difficulties in remembering personal events, people, and places than other neurological patients.

Question 17

What is often shown regarding information processing speed in epilepsy patients?

Answer 17

They frequently display slowed information processing.

Question 18

Slowing of information processing speed is associated with what kind of organization in the brain?

Answer 18

Reduced efficient organization between the visual perception network and both dorsal and ventral attention networks.

Question 19

Where are executive dysfunctions mainly expected?

Answer 19

In frontal epilepsy.

Question 20

What language problems are commonly seen in children with epilepsy syndromes like Landau-Kleffner syndrome?

Answer 20

Difficulty recognizing and understanding words and/or speech.

Question 21

Which language-related problem is especially prevalent in left temporal lobe epilepsy?

Answer 21

Naming and word-finding problems.

Question 22

How is Theory of Mind (ToM) affected in patients with certain types of epilepsy?

Answer 22

It is impaired in patients with frontal, temporal, or generalized epilepsy.

Question 23

How does the risk of developing dementia differ between epilepsy patients and those without epilepsy?

Answer 23

Patients with epilepsy have up to three times higher risk, especially with late-onset epilepsy.

Question 24

Which two conditions often co-occur with epilepsy?

Answer 24

PNES and psychogenic non-epileptic seizures.

Question 25

Which neurological disorder is most common in individuals under 50?

Answer 25

Traumatic Brain Injury (TBI).

Question 26

What is PTA in the context of brain injury?

Answer 26

Post-traumatic amnesia, a transient state characterized by confusion and disorientation following a trauma.

Question 27

What are the three clinical phases of TBI presentation?

Answer 27

The acute phase (up to one month), the sub-acute phase (1-6 months), and the chronic phase.

Question 28

How is brain damage categorized in traumatic brain injury?

Answer 28

It can be primary (immediate damage) or secondary (hours or days after injury).

Question 29

What causes primary brain damage in TBI?

Answer 29

Direct mechanical forces, leading to cell damage and cell death, with microglia activation.

Question 30

What are the causes of secondary brain damage in TBI?

Answer 30

Intracranial complications, cerebral edema, injury as a result of hypotension and shock, or damage due to certain infections like meningitis.

Question 31

How does memory get impacted after TBI?

Answer 31

Patients might experience post-traumatic amnesia initially, followed by issues with remembering recent events and learning new information.

Question 32

Which area of the brain, when damaged, can particularly affect memory retrieval in TBI patients?

Answer 32

The temporal lobe.

Question 33

What characterizes Mild Traumatic Brain Injury (mTBI)?

Answer 33

t involves a short duration of loss of consciousness with few or no post-traumatic abnormalities. Most recover fully.

Question 34

What is a notable difference between patients with mild TBI and those with more severe injuries regarding cognitive complaints?

Answer 34

Patients with mild TBI report more cognitive complaints, but MRI studies show no relationship between these complaints and actual brain damage.

Question 35

Which cognitive domains remain largely unaffected even in severe brain injuries?

Answer 35

Processing speed tasks unless they involve abstracting and logical reasoning.

Question 38

Is radiotherapy necessary for all brain tumors?

Answer 38

No. For meningiomas, resection is often sufficient. Radiotherapy is mostly used for gliomas.

Question 39

What are the side effects of cytostatic chemotherapy?

Answer 39

It can cause neurotoxicity, which is especially dangerous when the blood-brain barrier has already been disrupted.

Question 40

What is encephalopathy as a consequence of radiotherapy?

Answer 40

It’s an inflammatory response in the brain, typically short-term, after radiotherapy.

Question 41

What are corticosteroids used for in relation to brain tumors?

Answer 41

They are given to reduce intracranial pressure by reducing the edema around the tumor.

Question 43

What is the chronic neurological disorder characterized by inflammation and neurodegeneration in the central nervous system?

Answer 43

Multiple Sclerosis (MS).

Question 44

Who is more likely to develop MS, men or women?

Answer 44

Women are twice as likely to develop MS than men.

Question 45

List some contributing factors to the cause of MS.

Answer 45

Vitamin D deficiency, obesity at a young age, infection with the Epstein-Barr virus, and heritable (genetic) factors.

Question 46

What are the primary and secondary responses in MS according to the ‘inside-out’ hypothesis?

Answer 46

The primary damage starts with the neurodegeneration of axons or oligodendrocytes in CNS.
This degeneration releases myelin antigens which then activate the immune response. Thus, the immune reaction is secondary to an inherent CNS pathology.

Question 47

What happens during a relapse in MS according to the outside-in hypothesis

Answer 47

Immune cells (T- and B-cells) enter the brain and attack the brain’s own myelin, known as an autoimmune reaction.

Question 48

What is the characteristic of Progressive Relapsing MS (PRMS)?

Answer 48

Least common type.
A steady worsening disease from the beginning but with clear superimposed relapses.
There may or may not be recovery after these relapses.

Question 49

Describe the Relapsing Remitting MS (RRMS) disease course.

Answer 49

Most common type of MS.
Defined by episodes of acute worsening of neurologic function (relapses) followed by partial or complete recovery periods (remissions) with no evidence of disease progression during the remissions.

Question 50

How does Secondary Progressive MS (SPMS) evolve?

Answer 50

Initially starts as RRMS but eventually transitions into a phase characterized by a steady progression of neurologic decline.

Question 51

What defines Primary Progressive MS (PPMS)?

Answer 51

Characterized by steadily worsening neurologic function from the onset of symptoms without early relapses or remissions.

Question 52

Define Clinically Isolated Syndrome (CIS) in the context of MS.

Answer 52

CIS is a single episode with MS symptoms. If another episode occurs in 2/3 people, an MS diagnosis can be given.

Question 53

Where does neurodegeneration and demyelination take place in the brain?

Answer 53

Both in the white and grey matter of the brain.

Question 54

What is the McDonald criteria related to MS?

Answer 54

The McDonald criteria states there must be dissemination in place and time, meaning damage at multiple locations and at multiple times.

Question 55

How does an MRI assist in diagnosing MS?

Answer 55

MRI visualizes white matter abnormalities like lesions, detects inflammation using contrast agents, and shows neurodegeneration in white and grey matter.

Question 56

Which part of the brain can show atrophy in MS patients?

Answer 56

Cerebral cortex and thalamus.

Question 57

Is there a gender difference in the likelihood of having MS and its cognitive impairment profile?

Answer 57

Men are less likely to have MS. However, if they do, their cognitive deterioration is faster. But, the cognitive impairment profile doesn’t differ between men and women.

Question 58

How might higher education impact cognitive impairments in MS?

Answer 58

People with higher education may develop cognitive impairments later than those with less education. However, once reserve capacity is depleted, the level of cognitive functioning becomes similar.

Question 59

How do demyelination and cognitive reserves relate in terms of cognitive slowing?

Answer 59

Demyelination causes cognitive slowing, but until ¾ of the white matter is damaged, cognitive reserves can compensate for the impairment.