Epilepsy Flashcards
(52 cards)
Define epileptic seizure
A transient event experienced by a subject as a result of a synchronous and excessive discharge of cerebral neurones
Define epilepsy
The continuous tendency to have epileptic seizures
- arises secondary to pathological process
Define prodrome
A change in behaviour noticed by patient or others which may precede the seizure
- not part of seizure itself
- may last hours/days
Define Aura
A strange feeling in the gut, an experience of deja-vu or strange smells/flashing lights
- patient is aware
- may precede other manifestations
- implies a partial seizure quite often
Define post-ictal period?
Period following seizure where symptoms may occur
Describe post-ictal Sx that may occur
Headache, confusion, myalgia, sore tongue
Temporary weakness after focal seziure in motor cortex
Dysphasia - following temporal lobe focal seizure
Name two features in the history that a typical of epileptic seizures
Tongue biting
Slow recovery
Describe the two general classification categories of epileptic seizures
Generalised seizures
Partial seizures (focal seizures)
Name six types of generalised seizure
Absence seizures
Tonic-clonic seizures
Myoclonic
Tonic seizures
Atonic seizures (akinetic seizures)
Infantile spasms
At what stage of life do absence seizures usually develop?
Childhood
Describe an absence seizure
Loss of awareness and vacant expression for less than 10 seconds before returning abruptly to normal, continuing as if nothing has happened
Describe a tonic-clonic seizure
Often no prodrome but may have aura if secondary generalised
Tonic clonic phase
- initial tonic stiffening followed by clonic phase with synchrounous jerking of the limbs which reduce in freq over about 2 mins until convulsion stops
- eyes remain open, often tongue biten
- may be incontinence of urine or faeces
Post-ictal phase
- Period of flaccid unresponsiveness -> gradual return of awareness
- confusion and drowsiness lasting a while
- headache
Describe myoclonic seizures
Take the form of momentary brief contractions of a muscle or muscle groups
- sudden involuntary twitch of a finger or hand
Describe atonic seizures
Sudden loss of muscle tone causing a fall (no LoC)
What is commonly associated with infantile spasms?
Tuberous sclerosis
- genetic disease that causes beningn tumours to grown in the brain and other vital organs
What is a primary generalised seizure?
Simultaneous involvement of both hemispheres - always associated with LoC and LoA
What is partial seizure?
Electrical discharge constricted to a limited part of cortex of one cerebral hemisphere
Describe a simple partial seizure
Partial seizure without loss of awareness
- e.g. one limb jerking
Originates in motor cortex, can spread to involve the entire hemisphere
Describe a complex partial seizure
Partial seizure with loss of awareness
- usually arise from temporal lobe (60%) or frontal lobe
Post-ictal confusion is common with temporal lobe seizures
- rapid recovery in frontal lobe
What is a secondary generalisation seizure?
Electrical disturbance from partial seizures spreads widely causing a generalised seizure
- typically convulsive
What are the features of temporal lobe seizures?
Automatisms - complex motor phenomena with impaired awareness and no afterward recollection
Abdominal rising sensation or pain
Dysphasia
Memory phenomena
Emotional disturbance - due to hippocampal involvement
Uncal involvement - hallucinations of taste or smell
Delusional behaviours
Give an example of automatisms involved in temporal lobe epilepsy
Primitive oral - lip-smacking, chewing
Manual movements - fumbling, fidling, grabbing
Complex actions - singing, kissing,…
What are the features of frontal lobe seizures?
Motor features - posturing, versive movements of head and eyes
Jacksonian march
Motor arrest
Subtle behavioural disturbance
Dysphasia or speech arrest
Post-ictal Todd’s palsy (motor weakness)
What are the features of occipital lobe seizures?
Visual phenomena - spots, lines, flashes
