Flashcards in Epilepsy Deck (48):
Describe the symptoms of an epileptic seizure?
paroxysmal, inappropriate, hypersynchronous, self-sustained neuronal network activity
disease modifying epilepsy requires?
what is a partial/focal seizure?
seizure that arises in a limited number of cortical neurons within one hemisphere
where in the world is there more cases of epilepsy?
consequences of epilepsy? 5 classes:
medication side effects
people with epilepsy mortality ratio?
3 to 1
epilepsy is most common cause of death in who?
sudden unexplained death in epilepsy
ECG in epilepsy shows?
discharge loops, hyper synchronous
how long do seizures normally last?
epilepsy vs. seizures?
epilepsy means you're more predisposed to seizures, having a seizure does not mean you have epilepsy
3 main causes of epilepsy?
what is a generalised seizure?
arises simultaneously in both hemispheres
what kind of epilepsy is it where the underlying brain structure and function is normal? who normally get these.
Genetic epilepsy in kids, how to treat? what is the underlying problem likely?
1. respond well to meds
2. usually ion channel defect
what kind of epilepsy can you get normally as you get older?
structural/metabolic epilepsy course? treatment?
1. uncommonly remit
2. incompletely controlled with meds
why important to get proper detailed epilepsy dx?
treatment options differ widely
Thomas Willis postulated that epilepsy source was?
within the brain
Hughlings Jackson said seizures result from?
focal grey matter pathology
what would cause the uncontrolled firing of neurons in seizures?
no balance between inhibition and excitation of neurons and networks
imbalance in neurons can be caused by what in the connections? 4 things:
1. aberrant sprouting
2. altered excitability
3. altered transmission
4. altered glial environment
what is the most sensitive structure to induce seizures? where is it?
medial temporal lobe structure
what are the 4 main subregions of hippocampus?
Hippocampus is important in?
learning and memory
Histopathology of epilepsy shows what? where?
1. Mesial Temporal sclerosis(MTS)
Mesial Temporal sclerosis(MTS) consists of 3 features?
1. cell loss in CA1,3, dentate
2. mossy fibre sprouting
uncertain about the progression of seizures of epilepsies and if?
seizures beget seizures
Age and epilepsy?
bimodal peak, increased risk young and elderly
childhood onset of epilepsy most likely because of?
congenital/perinatal CNS insults
reason for late childhood/early adulthood onset epilepsy?
reason for adult/elderly epilepsy?
what increases you chances of having epilepsy 60x?
most ppl with idiopathic generalized epilepsies have?
MRI epilepsy usually find focal lesions of what kind in epilepsy?
70% medically refractory
20% new onset seizures
mesial temporal sclerosis means what for treatment?
mesial temporal sclerosis good candidates for what treatment?
mesial temporal sclerosis most common cause of?
adults with partial epilepsy
2 most common cause of drug resistant epilepsy?
malformation of cortical development
aetiology of focal cortical dysplasia?
what is the condition of inherited generalized malformation due to abnormal neuronal migration causing epilepsy?
periventricular nodular heterotopia
most common cause of new onset partial seizures?
low grade tumours
most common type of low grade tumour causing epilepsy?
gliomas affecting cortial>subcortical
10% of patients with drug resistant partial epilepsy have? what two major ones?
vascular lesions: blood in brain can cause seizures
2. ateriovenous malformations
what is a cavernoma?
tangled mass of vessels slowing blood flow causing seizures
anti-epileptic drugs treat what?
symptoms only not underlying condition
how long take epilepsy drugs for?
3 non med epilepsy Rx?