6.3 Flashcards
(12 cards)
- Define epilepsy and explain the difference between a seizure and epilepsy.
Epilepsy is a chronic neurological disorder characterized by recurrent, unprovoked seizures resulting from abnormal, hypersynchronous electrical activity in the brain; in contrast, a seizure is a single episode of such abnormal activity that may occur once, often triggered by an acute event.
- What are some common clinical manifestations of seizures?
Seizures can present with a variety of symptoms depending on their type, including convulsions, tonic (stiffening) and clonic (jerking) movements, loss of consciousness or altered awareness, automatisms (repetitive involuntary movements), sensory disturbances, and brief staring spells.
- How are epileptic seizures classified according to the International League Against Epilepsy (ILAE)?
Seizures are classified by their onset as focal (originating in a specific area of the brain), generalized (involving both hemispheres from the start), or of unknown onset. Focal seizures may be further described as motor or non-motor, while generalized seizures include subtypes such as tonic-clonic, absence, myoclonic, and others.
- What are some examples of common epilepsy syndromes?
Examples include focal epilepsy (often associated with localized brain lesions), generalized epilepsy (such as primary generalized tonic-clonic seizures), and absence seizures (brief lapses in awareness typically seen in childhood absence epilepsy), as well as specific syndromes like Lennox-Gastaut, Dravet, and Juvenile Myoclonic Epilepsy.
- Identify common risk factors and triggers for developing epilepsy.
Risk factors include head trauma, infections (e.g., encephalitis, meningitis), stroke, brain tumors, genetic predispositions, and metabolic imbalances. Environmental factors such as drug or alcohol abuse and even specific sensory triggers (like flashing lights) in susceptible individuals can precipitate seizures.
- Explain the basic neurophysiological mechanisms underlying seizure generation.
Seizures arise when there is an imbalance between excitatory and inhibitory neuronal activity. Increased excitatory signals (often mediated by glutamate) or decreased inhibitory signals (mediated by GABA) can disrupt normal neuronal homeostasis, leading to hypersynchronous and repetitive firing of neurons.
- How do imbalances between neurotransmitters such as GABA and glutamate contribute to epilepsy?
A decrease in the inhibitory neurotransmitter GABA or an excess of the excitatory neurotransmitter glutamate creates an imbalance in neural circuits, leading to hyperexcitability and the generation of seizures. This imbalance disrupts the normal control of neuronal firing and facilitates the spread of abnormal electrical discharges across the brain.
- Describe how genetic mutations can play a role in the development of epilepsy.
Mutations in genes that regulate ion channels, neurotransmitter receptors, and synaptic function (for example, in sodium channels or GABA receptors) can alter neuronal excitability. Both inherited and de novo mutations contribute to epilepsy, and these genetic changes may be identified through genetic testing, aiding in diagnosis and tailored treatment.
- What is the role of EEG in the diagnosis and classification of seizures?
Electroencephalography (EEG) records the electrical activity of the brain and is used to detect characteristic patterns – such as spikes and waves – that help differentiate between focal and generalized seizures, thereby informing diagnosis, classification, and treatment planning.
- How does epilepsy impact the quality of life and long-term care for patients, especially in special populations?
Epilepsy can adversely affect quality of life due to unpredictable seizures, side effects of medication, cognitive impairment, social stigma, and restrictions in daily activities. In special populations—such as children, older adults, or those with refractory seizures—managing epilepsy often requires comprehensive, multidisciplinary care to address both medical and psychosocial needs.
- What challenges are often encountered when managing epilepsy in special populations?
In children, challenges include developmental delays, educational impacts, and long-term medication effects, whereas older adults face issues such as polypharmacy, comorbid conditions, and increased sensitivity to medications. Each group’s unique needs require tailored therapeutic approaches and support services.
- Summarize why understanding both clinical manifestations and underlying pathophysiology is crucial in the management of epilepsy.
A thorough understanding of both the observable symptoms (clinical manifestations) and the underlying neurophysiological disturbances (such as neurotransmitter imbalances and genetic factors) is crucial to accurately diagnosing, classifying, and treating epilepsy. This dual approach enables personalized treatment strategies that improve seizure control and overall quality of life.
