13 Flashcards
(23 cards)
What is the significance of 90 minutes when you manipulate sleep?
The 90 minutes of sleep you get is the full sleep cycle, allowing you to wake up after your REM state, instead of during
What are three types of insomnia based on how long they last? What are three sleep
disturbance patterns that count as insomnia?
Transient Insomnia: lasts for a few days to a week. Causes include: stress, jet lag, or worrying.
Acute Insomnia: can last for several weeks. Causes: sickness, stress, bereavement over the loss or death of someone.
Chronic Insomnia: lasts for months or years. Causes: poor sleep environment, mistiming your sleep, long term health problems or long term stress.
What is the incidence of insomnia?
1 in 4 adults
What happens in sleep apnea (in general)? What is the prevalence of sleep apnea?
CO2 level in the blood goes up and sends signals to the medulla and wakes you up. Person stops breathing repeatedly during the night which results in oxygen deprivation
for the brain or entire body. Prevalence: 3%-4% of population
How does obstructive sleep apnea work’? What is central sleep apnea?
Obstructive: tongue and other soft tissue relaxes too much during sleep and collapses to
cover the airway passage in your throat
Central: brain fails to send signals to the body during sleep that you have to keep
breathing
How much of sleep apnea is obstructive as opposed to central?
80% Obstructive
20% central
What is the standard therapy for sleep apnea? What is the main problem with this therapy?
People are usually prescribed CPAP machines which continuously pump air and push the tongue to the side so the person can breathe well. The main problem is it is uncomfy, hard to sleep with it in, and dries out the membrane.
low compliance
How common is narcolepsy?
20-45/100,000: rare
What is the main daytime symptom for sleep apnea?
Sleep attack – straight into REM sleep w/ vivid dreams, possible cataplexy (inhibition of movement), hypnagonic hallucinations (hallucinations you have when you’re about to fall asleep), sleep paralysis (wake up and can’t move)
Sleepiness
Slow reflexes
Poor concentration
Explain the difference between cataplexy and sleep paralysis.
Cataplexy condition in which strong emotion or laughter causes the person to physically collapse and remain unconscious
Sleep Paralysis: person temporarily unable to move, speak or talk while falling asleep or waking up
Explain the distinction between epilepsy and seizures.
Epilepsy: neurological disorder in which primary symptom seizures are generated by a brain dysfunction.
While NOT ALL seizures are result of epilepsy. (brain damage, tumors etc.)
What is the prevalence of epilepsy?
1%-4% have multiple seizure episodes.
1 in 20 have a mild insignificant seizure once
Describe the grand mal and petit mal seizure (old) classification. What types of seizures are
these on the new classification?
In the older classification, “grand mal” seizures were known as tonic-clonic seizures, characterized by Loss of consciousness and equillibrium, stiffening (tonic) followed by jerking (clonic) movements, while “petit mal” seizures were known as absence seizures, involving brief lapses of awareness.
What is the difference between a partial and generalized seizure? Where do they originate?
Partial Seizure: doesn’t involve the whole brain; originated in “seizure focus” and spreads through fibers to the thalamus
Generalized Seizure: involves the entire brain; originates in “seizure focus” and diffuses via interconnections between the thalamus and cortex throughout the entire brain
seizures caused by rapid firing of neurons in the brain. originate from a focus and spreads through fibers.
In which order are the brain lobes “epileptogenic”?
Temporal (30-50%); Frontal (20-25%); Parietal(5-6%); Occipital(5-6%)
What is the difference between simple and complex partial seizures?
Simple: no alteration in consciousness
Complex: altered consciousness and sensory or motor symptoms
What is a secondarily generalized seizure and what is the “Jacksonian march”?
Secondarily generalized seizure is when the seizure starts in one part of the brain and moves to another. Usually ends up in the thalamus. Jacksonian March has to do with Hughlings Jackson and the localization of function. The march is referring to a march of neurons while a seizure is occurring on one side of the brain, paralysis occurs on the ipsilateral part of the brain
What are the stages of an epileptic attack? What modalities can the aura be associated
with?
Aura - involves alterations in smell, taste, visual perception, hearing, and
emotional state
Seizure - also known as ictus
Postictal- drowsiness and confusion, period when the brain recovers from the seizure
What does tonic, clonic, atonic, and myotonic mean?
Tonic - muscle stiffness, rigidity
Clonic - repetitive jerking movements
Atonic - loss of muscle tone
Myotonic - sporadic (isolated) jerking movements
Why is the diagnosis ‘epilepsy’ a lengthy process to establish? What are the differential
diagnoses?
Diagnosing epilepsy is difficult because there are many other reasons why someone may get seizures like a different underlying health condition. You must monitor the symptoms and episodes for a longer time and assess which type of seizure they are having and where in the brain it is located.
Differential diagnosis: syncope, narcolepsy, migraines, panic disorders.
What types of therapy were discussed for epilepsy in class?
Medication—70% regulated; Keto diet; Neurosurgery—Removes affected portions
Extremely difficult to treat!
Primary Therapy: anti convulsants and dosage is administered by trial and error
Medication controls
35%-complex partial seiz
40%- petit mal
50%-tonic-clonic
Non-Medication: Ketogenic diet, diet low in carbs, used particularly in children
How many layers can most parts of the cortex be divided into? What are thought to be the
functions of these layers?
Cortex layers: I, II, III, IVa, IVb, IVc, V, VI
I-III is the integration layers
IVa-IVc are where the info comes in
V & VI are the output layers and where EEG signals come from
What is Brodmann’s division of the cortex into separate areas based on (i.e. why did he say
these areas were different?)
Cytoarchitectonic map – based on cell architecture, based on organization, structure, and distribution of cortical cells different numbers represent different functions and their locations
i. some areas have similar functions but if their architecture is different they will not be numbered together
