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Flashcards in Epilepsy Deck (13)

What is electroencephalography?

Electroencephalography is the recording of electrical activity along the scalp. EEG measures voltage fluctuations resulting from ionic current flows within the neurons of the brain.


What is epilepsy?

 A paroxysmal dysfunction of brain neurophysiology (as seen on EEG)
 Accompanied by a paroxysmal dysfunction in brain action (cognitive, behavioural, sensory, experiential)
 Which has a tendency to recur
They affect different parts of the brain and this will affect how you react. They're idiopathic.


What is a simple partial seizure?

 If the area of the brain affected by the seizure is small, this is called a simple partial seizure (SPS). The person will be awake and aware during the seizure and will remember what happened to them.


What is a complex partial seizure?

 If the area of the brain affected by the seizure is larger than that in the SPS, this causes a complex partial seizure (CPS). These seizures affect three things –
 the person’s awareness (they will be only partly conscious)
 their accessibility (they may not be able to respond to you)
 their memory (they may not remember the seizure).


What's a generalised seizure?

 In generalised seizures the seizure affects all the brain at once. Generalised seizures affect the persons consciousness. Because of this they will have no memory of the seizure.


What's a myoclonic seizure?

 ‘Myoclonic’ means ‘muscle jerk,’ which describes what happens during these seizures.
 Usually the arm or leg will briefly jerk, although it can be the head or trunk.
 These are similar to the jerks we all have just as we are falling asleep (Hypnagogic jerk), but they happen at other times during the day, often during the first few hours after waking–up. Usually, the person recovers quickly.


What is a secondary generalised seizure?

 Sometimes a partial seizure can become a generalised seizure and is called secondarily generalised seizure (as it starts out as a partial seizure and becomes generalised in the second part of the seizure).
 As the seizure starts as a simple or complex partial seizure, the person might be aware that the seizure has started but as it becomes generalised, they will lose consciousness.


What type of investigations can be done?

 EEG  MRI  Videotelemetry  CT scan  SPECT scan  PET scan


What treatment can be given?

 Medication eg. Carbamazepine
 Surgery – e.g. lobectomy, vagus nerve stimulator
 Complementary therapies (but be careful - always consult a specialist first)


What are the risk factors of SUDEP (sudden unexpected death in epilepsy)?

 Early onset  Male  20 – 40  Tonic-clonics  Nocturnal
 Living alone  Poor records  Poor seizure control
 Non-compliance
 Polytherapy
 Abrupt/frequent changes in AEDs
 alcohol
It's relatively uncommon.


What are the causes of epilepsy in the young?

 40% are idiopathic  40% developmental lesion  5% tumour  5% head injury


What are the causes of epilepsy in the old?

 Cerebro-vascular
 Tumour  Head Injury  Alzheimers  Also remember medication as a cause


What are the Psychiatric aspects of epilepsy?

 Psychoses : Ictal Peri-ictal
Inter-ictal  Mood disorders & anxiety
 Personality  Aggression  Non epileptic seizures