Epilepsy

Question 1

What is a seizure?

Answer 1

Sustained and synchronised electrical discharge in the brain which causes symptoms or signs

Question 2

Which neurotransmitters/ions can excite a neuron?

Answer 2

EAA
Action of NMDA/AMPA kainate channels
Sodium / calcium influx

Question 3

Which neurotransmitters/ions can inhibit a neuron?

Answer 3

GABA/glycine
action on GABA receptors
Chloride influx

Question 4

What is the other name for a generalised tonic-clonic seizure?

Answer 4

Bilaterally convulsive

Question 5

What is epilepsy?

Answer 5

A tendency to have recurrent unprovoked seizures

Question 6

What percentage of the population are affected by epilepsy?

Answer 6

0.5%

Question 7

List the common causes of epilepsy?

Answer 7

Vacular
Hippocampal sclerosis
Infection
Trauma
Tumour
Degenerative
Unknown

Question 8

What is the cause of faints in epilepsy?

Answer 8

Lack of blood to the brain

Question 9

What. is the cause of fits in epilepsy?

Answer 9

Electrical discharge

Question 10

Compare and contrast syncope and seizures

Answer 10

Syncope - common trigger, almost always has prodrome, gradual onset, 1-30second. duration, brief convulsions, incontinence uncommon, post-octal confusion is rare, recovery is rapid
Seizure rarely has a trigger, commonly has prodrome, lasts 1-3. mins, prolonged convulsive jerks, incontinence common, post-octal confusion common, recovery is slow

Question 11

Localised epilepsy can cause a generalised tonic-clonic seizure. T/F?

Answer 11

True

Question 12

There will be a positive neurological symptom at the onset of a localised seizure. t/f?

Answer 12

tRUE

Question 13

What investigations are used for possible epilepsy?

Answer 13

MRI

CT

Question 14

What investigation can be used to help classify epilepsy as generalised or localised in young people?

Answer 14

EEG

Question 15

Describe the mechanism of action of the anti-epileptic drugs pregabalin and gabapentin

Answer 15

Inhibit voltage gated calcium channels which drive neurotransmitter release

Question 16

Describe the mechanism of action of the anti-epileptic drugs carbamexapine, lamotrigine and oxcarbazepine?

Answer 16

Inhibit voltage gated sodium channels which increase nerve excitability and drive action potentials

Question 17

Describe the mechanism of action of the anti-epileptic drug retigabine

Answer 17

Increases activity of voltage gated potassium channels which reduce neuronal excitability

Question 18

Describe the mechanism of action of the anti-epileptic drug levetiracetam

Answer 18

Inhibits SV2A which is required for the release of neurotransmitters from vesicles

Question 19

Describe the mechanism of action of the anti-epileptic drugs vigabatrin and valproate

Answer 19

Inhibit degradation fo GABA

Question 20

Describe the mechanism of action of the anti-epileptic drug tiagabine

Answer 20

Inhibit removal of GABA from the synapse by the GABA transporter

Question 21

Describe the mechanism of action of the anti-epileptic drugs benzodiazepines, barbiturates, falbamate and topiramate

Answer 21

Increase GABA receptor activity to reduce neuronal activity

Question 22

Which anti-epileptic drug blocks AMPA receptors?

Answer 22

Parampanel

Question 23

Which anti-epileptics are used for epilepsy with a localised onset?

Answer 23

Lamotrigine
Carbamazepine
Levetiracetam

Question 24

Which anti-epileptics are used for epilepsy with a generalised onset?

Answer 24

Valproate
Levetiracetam
Lamotrigine

Question 25

Anti-epileptic drugs are affected in all patients. T/F?

Answer 25

False