Epilepsy Flashcards Preview

Jason's Neuro Block > Epilepsy > Flashcards

Flashcards in Epilepsy Deck (48)
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1
Q

Describe the symptoms of an epileptic seizure?

A

paroxysmal, inappropriate, hypersynchronous, self-sustained neuronal network activity

2
Q

disease modifying epilepsy requires?

A

multifaceted approaches

3
Q

what is a partial/focal seizure?

A

seizure that arises in a limited number of cortical neurons within one hemisphere

4
Q

where in the world is there more cases of epilepsy?

A

developing countries

lowersocioeconomics

5
Q

consequences of epilepsy? 5 classes:

A
physical injury
psychiatric
social
medication side effects
mortality
6
Q

people with epilepsy mortality ratio?

A

3 to 1

7
Q

epilepsy is most common cause of death in who?

A

young people

sudden unexplained death in epilepsy

8
Q

ECG in epilepsy shows?

A

discharge loops, hyper synchronous

9
Q

how long do seizures normally last?

A

60-90 seconds

10
Q

epilepsy vs. seizures?

A

epilepsy means you’re more predisposed to seizures, having a seizure does not mean you have epilepsy

11
Q

3 main causes of epilepsy?

A

genetic
structural/metabolic
unknown

12
Q

what is a generalised seizure?

A

arises simultaneously in both hemispheres

13
Q

what kind of epilepsy is it where the underlying brain structure and function is normal? who normally get these.

A

genetic

usually kids

14
Q

Genetic epilepsy in kids, how to treat? what is the underlying problem likely?

A
  1. respond well to meds

2. usually ion channel defect

15
Q

what kind of epilepsy can you get normally as you get older?

A

structural/metabolic

16
Q

structural/metabolic epilepsy course? treatment?

A
  1. uncommonly remit

2. incompletely controlled with meds

17
Q

why important to get proper detailed epilepsy dx?

A

treatment options differ widely

18
Q

Thomas Willis postulated that epilepsy source was?

A

within the brain

19
Q

Hughlings Jackson said seizures result from?

A

focal grey matter pathology

20
Q

what would cause the uncontrolled firing of neurons in seizures?

A

no balance between inhibition and excitation of neurons and networks

21
Q

imbalance in neurons can be caused by what in the connections? 4 things:

A
  1. aberrant sprouting
  2. altered excitability
  3. altered transmission
  4. altered glial environment
22
Q

what is the most sensitive structure to induce seizures? where is it?

A

Hippocampus

medial temporal lobe structure

23
Q

what are the 4 main subregions of hippocampus?

A

dentate gyrus

CA 1,2,3

24
Q

Hippocampus is important in?

A

learning and memory

25
Q

Histopathology of epilepsy shows what? where?

A
  1. Mesial Temporal sclerosis(MTS)
26
Q

Mesial Temporal sclerosis(MTS) consists of 3 features?

A
  1. cell loss in CA1,3, dentate
  2. mossy fibre sprouting
  3. gliosis
27
Q

uncertain about the progression of seizures of epilepsies and if?

A

seizures beget seizures

28
Q

Age and epilepsy?

A

bimodal peak, increased risk young and elderly

29
Q

childhood onset of epilepsy most likely because of?

A

congenital/perinatal CNS insults

30
Q

reason for late childhood/early adulthood onset epilepsy?

A

idiopathic/genetic

31
Q

reason for adult/elderly epilepsy?

A

acquired/trauma/structural

32
Q

what increases you chances of having epilepsy 60x?

A

Alzheimer’s

33
Q

most ppl with idiopathic generalized epilepsies have?

A

genetic inheritance

34
Q

MRI epilepsy usually find focal lesions of what kind in epilepsy?

A

70% medically refractory

20% new onset seizures

35
Q

mesial temporal sclerosis means what for treatment?

A

drug resistance

36
Q

mesial temporal sclerosis good candidates for what treatment?

A

surgery

37
Q

mesial temporal sclerosis most common cause of?

A

adults with partial epilepsy

38
Q

2 most common cause of drug resistant epilepsy?

A

malformation of cortical development

39
Q

aetiology of focal cortical dysplasia?

A

unknown

40
Q

what is the condition of inherited generalized malformation due to abnormal neuronal migration causing epilepsy?

A

periventricular nodular heterotopia

41
Q

most common cause of new onset partial seizures?

A

low grade tumours

42
Q

most common type of low grade tumour causing epilepsy?

A

gliomas affecting cortial>subcortical

43
Q

10% of patients with drug resistant partial epilepsy have? what two major ones?

A

vascular lesions: blood in brain can cause seizures

  1. cavernoma
  2. ateriovenous malformations
44
Q

what is a cavernoma?

A

tangled mass of vessels slowing blood flow causing seizures

45
Q

anti-epileptic drugs treat what?

A

symptoms only not underlying condition

46
Q

how long take epilepsy drugs for?

A

years/lifetime

47
Q

3 non med epilepsy Rx?

A

surgery
neurostim
dietary

48
Q

when do epilepsy surgery?

A

focal localized drug-resistance epilepsy