Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BB Test 4 > Epilepsy & EEG > Flashcards

Epilepsy & EEG Flashcards

1
Q

What are the two major excitatory neurotransmitters and what neurons typically form excitatory synapses?

A

Neurotransmitters:

  • Glutamate (main)
  • Aspartate

Principal neurons (Na+ and Ca2+ influx)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the two major inhibitory neurotransmitters and what neurons typically form inhibitory synapses?

A

Neurotransmitters:

  • GABA (main)
  • Glycine

Interneurons (Cl- influx, K- efflux)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Repetitive activation of action potentials produces what type of firing in neurons?

A

Burst firing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Burst firing especially occurs in what part of the brain?

A

Hippocampus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does excessive glutamate result in?

A

Seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Activation of what type of receptors plays an important role in the spread of epileptic activity?

A

NMDA receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe “recurrent excitatory pathways” and their significance to seizures.

A
  • Recurrent excitatory pathway occurs in the hippocampus and neocortex via pyramidal collaterals.
  • This provides activation that is normally governed by widespread inhibitory circuits.
  • Promotes spread of the seizure discharge.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What part of the brain anatomy promotes epileptogenesis?

A

Hippocampus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What hippocampal “disease” is common in temporal lobe epilepsy?

A

Hippocampal sclerosis (see in long-standing epilepsy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does hippocampal sclerosis affect epilepsy?

A
  • Synaptic reorganization and increased axonal collateralization provide increased excitatory input between neurons. (the more seizures you have, the easier it is to have another one because connections are strengthened)
  • This promotes synchronous epileptic firing and seizure propagation.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

High frequency repetitive firing results in accumulation of what?

A

Ca2+ near the presynaptic terminal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does high frequency repetitive firing (and accumulation of Ca2+ at the presynaptic terminal) result in synaptic enhancement?

A
  • Facilitation: Increased glutamate release
  • Potentiation: Enhanced synaptic activity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How does repetitive neuronal firing affect synaptic inhibition?

A

Repetitive neuronal firing DEPRESSES inhibitory (GABA) synaptic activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe how electrical coupling of neurons affects epilepsy.

A

In areas with densely packed neurons (hippocampus), neurons may be connected directly via gap junctions, or ephaptic transmission due to close apposition of membranes, allowing direct propagation of seizure discharge.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the 5 major cellular mechanisms of epilepsy? (KNOW THIS)

A
  • Modification or alteration of ion channels
  • Synaptic reorganization and modificatoin
  • Modulation of gene expression
  • Burst firing
  • Recurrent excitatory connections
  • Synaptic enhancement and potentiation produced by rapid firing
  • Depression of inhibitory synapses by high frequency firing
  • Nonsynaptic spread of electrical activity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Define epilepsy.

A

Recurrent seizures produced by abnormal repetitive neuronal firing in the brain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the most common cause of single seizures (especially in pediatrics)?

A

Febrile seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the two major categories of seizure?

A

Focal (partial)

Primary generalized

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe the eptileptiform discharges of EEG in epilepsy.

A

Indicate susceptibility to seizures

May be generalized or focal.

  • Generalized: Spike wave
  • Focal: Spikes or sharp waves
20
Q

Why is it important to correctly classify seizures?

A

To choose the correct antiepileptic drug.

21
Q

What is Lennox-Gastaut Syndrome?

A

Type of epilepsy with the following characteristics:

  • Onset early in childhood, difficult to treat
  • Many causes, mostly cryptogenic (unknown cause)
  • Multiple Seizure Types
    • Atypical absence
    • Generalized convulsive
    • Atonic (results in frequent injury or falls)
    • Myoclonic
    • Partial
  • Results in negative underdevelopmental impact (mental retardation)
  • Slow spike and wave (2Hz)
22
Q

What is an atonic seizure?

A
  • Seizure with no warning (abrupt onset)
  • Injuries are common
  • Difficult to treat
  • May respond to Vagal Nerve Stimulator (VNS) - Maintains vagal tone to prevent seizures
  • Corpus callosotomy may prevent falls
23
Q

What type of epilepsy remits by 15-16 years of age or earlier?

A

Benign focal epilepsy of childhood

24
Q

How do patients having an absence seizures present?

A
  • Brief stares and states of unresponsivenesss
  • May experience associated eye flutters (eyelid myoclonia)
  • Sudden onset with arrest of activity
  • No aura or postictal confusion
  • Generalized 3Hz spike and wave
  • Does not cause brain damage
25
Q

What are the characteristics of primary generalized convulsive seizures?

A
  • No warning (abrupt onset)
  • May result in tonic, clonic, tonic-clonic, or clonic-tonic-clonic activity.
  • May experience bowel and bladder incontinence
  • Postictal unresponsiveness or confusion
  • Generalized spikes and waves on the patient’s EEG
26
Q

What is the classic clinical feature of myoclonic seizure?

A
  • Sudden single jerks of the arms and head
  • Single or in clusters
  • No alteration in consciousness
  • May progress to clonic-tonic-clonic seizure
  • Generalized multispike wave
27
Q

Vagal nerve stimulation and corpus callosotomy may be viable treatments in ____________ seizures.

A

Atonic

28
Q

__________ is the general “premonition” that a seizure is about to occur. This feeling is usually caused by a brief partial seizure.

A

Aura

29
Q

What type of seizure is characterized by an acute arrest of activity?

A

Absence

30
Q

When focal seizures spread to involve the entire brain, it is referred to as __________________.

A

Secondary generalization

31
Q

What is a focal seizure?

A

Seizures conceptualized as originating at some point within networks limited to one hemisphere

  • Can maintain consciousness
32
Q

What is a generalized seizure?

A

Seizures conceptualized as originating at some point within and rapidly engaging bilaterally distributed networks

33
Q

What are common types of epilepsy seen in the neonatal period?

A
  • Benign familial neonatal epilepsy (BFNE)
  • Early myoclonic encephalopathy (EME)
  • Ohtahara syndrome
34
Q

What is a common type of epilepsy seen in the infancy period?

A

West Syndrome (KNOW THIS)

35
Q

What are common types of epilepsy seen in the childhood period?

A
  • Panayiotopoulos Syndrome
  • Benign epilepsy with centrotemporal spikes (BECTS)
  • Lennox-Gastaut Syndrome
  • Childhood absence epilepsy (CAE)
36
Q

What are common types of epilepsy seen in the adolescence-adult period?

A
  • Juvenile absence epilepsy (JAE)
  • Juvenile myoclonic epilepsy (JME)
37
Q

What type of epilepsy is associated with laughing fits?

A

Gelastic seizures with hypothalamic hamartoma

38
Q

What is West Syndrome? What usually is the cause of it?

A
  • Flexion or extension spasms (looks like startle reflex) AKA Infantile Spasms
  • Usually occur in clusters
  • Peak onset is 5-6 months
  • Commonly from injury (i.e. Shaken Baby Syndrome) but there are many potential causes
  • Not responsive to phenobarbital
  • Hypsarrhythmia EEG pattern
39
Q

What is the EEG pattern for West Syndrome (Infantile Spasms)?

A

Hypsarrhythmia (high amplitude and irregular waves and spikes in a background of chaotic and disorganized activity)

  • Seen when infant is NOT seizing
40
Q

What is the EEG pattern for Lennox-Gastaut Syndrome?

A

Slow spike and wave (2Hz)

41
Q

What is characteristic of a frontal lobe seizure? What is another name for it?

A
  • Seizure is the EXACT SAME every time
  • Aura is common
  • Focal onset
  • May secondarily generalize

Focal Seizure without Impairment of Consciousness (Simple Partial)

42
Q

What is characteristic of a focal temporal lobe seizure? What is another name for it?

A
  • Aura is common
  • Alteration of consciousness
  • Automatisms (vocalization is common, they get restless)
  • Postictal confusion
  • May secondarily generalize

Focal Seizure with Impariment of Consciousness (Complex Partial)

43
Q

Nocturnal seizures are common with what type of epilepsy?

A
  • Benign Epilepsies of Childhood
    • Benign Epilepsy with Centrotemporal Spikes (BECTS)
    • Panayiotopoulos Syndrome (Benign Epilepsy with Occipital Spikes)
  • Usually goes away by 15 - 16 years of age
  • Seizures are usually infrequent
44
Q

What is the inheritance pattern for Juvenile Myoclonic Epilepsy (JME)?

A

Autosomal dominant

45
Q

What are some examples of epilepsy surgeries?

A
  • Temporal lobectomy (75-90% seizure free)
  • Extratemporal lesional resection (50-75% seizure free)
  • Extratemporal non-lesional resection (<50% seizure free)
  • Functional hemispherectomy
  • Corpus callostomy (especially for atonic and brief tonic seizures)

BB Test 4 (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions