Epilepsy and Neurophysiology

Question 1

What is epilepsy?

Answer 1

Chronic CNS disorders characterized by recurrent seizures

Question 2

What is a seizure?

Answer 2

Sudden, transitory, and uncontrolled episodes of brain dysfunction resulting from abnormal discharge of neuronal cells with associated motor, sensory, and behavioral changes

Question 3

What is the type of diet used for a child who has a multiple seizure type?

Answer 3

Ketogenic: high fat, low glucose

Question 4

What are the side effects to a ketogenic diet?

Answer 4

Kidney stones, weight loss, acidosis, dyslipidemia

Question 5

What classifies epileptic seizures?

Answer 5

Idiopathic and symptomatic

Question 6

What are the different types of channelopathies?

Answer 6

Modification of channel function, activation of second-messenger system that affect channel function , modulation of gene expresion

Question 7

What are the inherited types of mutations?

Answer 7

Voltage or ligand gated ion channels, if simple gene mutations

Question 8

What are the acquired types of mutations?

Answer 8

Auto-immune, changes after seizures

Question 9

What genes will you see a mutated gene for sodium channels?

Answer 9

SCN1A, SCN1B, SCN2A1

Question 10

What genes will you see a mutated gene for chloride channels?

Answer 10

CLCN2A

Question 11

What types of seizures are associated with chloride channel mutations?

Answer 11

Juvenile absence epilepsy, juvenile myoclonic epilepsy, epilepsy with grand mal upon awakening

Question 12

What is kindling?

Answer 12

Minor, rapid fire electrical signals happening in succession
Alone they don’t cause a seizure but together they do

Question 13

Where is a very likely location of a partial seizure?

Answer 13

Amygdala and hippocampus (70%)

Question 14

What are the two main types of stem cell niches in the brain?

Answer 14

Subventricular zone and subgranular zone of hippocampus

Question 15

What is the implication of having less stem cell niches in the brain?

Answer 15

Decrease is due to seizures

Question 16

What area of the hippocampus is susceptible to hypoxia?

Answer 16

Cell bodies of CA1

Question 17

Describe partial seizures.

Answer 17

Affects limited areas of the brain, most common type, simple and complex, can spread causing a secondary generalized seizure

Question 18

What is the defining feature of a simple partial seizure?

Answer 18

No cognitive effects

Question 19

What is the defining feature of a complex partial seizure?

Answer 19

Loss of awareness

Question 20

What type of partial seizure will you see from the frontal region?

Answer 20

Motor, bizarre, brief, nocturnal

Question 21

What type of partial seizure will you see from the temporal region?

Answer 21

Fear, amnesia, automatism

Question 22

What type of partial seizure will you see from the parietal region?

Answer 22

Somato-sensory, dizziness

Question 23

What type of partial seizure will you see from the occipital region?

Answer 23

Visual, often propagate with false localization

Question 24

Where is a seizure likely to spread through from one hemisphere to another ?

Answer 24

Anterior commisure

Question 25

What are the characteristics of a simple partial seizure (Jacksonian)?

Answer 25

Involves one side of brain at onset, focal, motor, sensory, speech disturbances, single limb/muscle group, no alteration of consciousness

Question 26

What type of EEG will you see with simple partials?

Answer 26

Excessive synchronized discharge - contralateral discharge

Question 27

What are the characteristics of a complex partial seizure?

Answer 27

Produces confusion and inappropriate or dazed behavior, no-reflexive actions, automatism, consciousness impaired/lost

Question 28

What type of EEG will you see with complex partials?

Answer 28

Bizarre generalized, anterior temporal lobe focal abnormalities, bilateral

Question 29

What are the generalized seizures?

Answer 29

Absence, myoclonic, atonic, tonic, tonic-clonic

Question 30

What are the general characteristics for generalized seizures?

Answer 30

Affects both hemispheres, more common in children

Question 31

What occurs in the tonic phase of a tonic-clonic seizure?

Answer 31

Contraction of all muscles which arrests ventilation

Question 32

What does the EEG look like in the tonic phase of tonic-clonic?

Answer 32

High rhythmic frequency, high voltage discharge, sustained depolarization

Question 33

What occurs in the clonic phase of a tonic-clonic?

Answer 33

Alternating contraction and realization, causing reciprocating movement which could be bilaterally symmetrical or running movements

Question 34

What does the EEG look like in the clonic phase of tonic-clonic?

Answer 34

Groups of spikes on the EEG and periodic neuronal depolarization with clusters of action potentials

Question 35

What are absence seizures?

Answer 35

Brief and abrupt loss of consciousness, sometimes motor symptoms, symmetric clonic motor activity, short duration but can happen may times a day

Question 36

When to absence seizures usually start?

Answer 36

Childhood

Question 37

What is found to be the expect cause of absence seizures?

Answer 37

A low threshold Ca2+ current has been found to govern oscillatory response in thalamic neurons

Question 38

What does the EEG look like for an absence seizure?

Answer 38

Bilaterally synchronous, high voltage, spike phase with short duration

Question 39

What is a tonic seizures?

Answer 39

Motor contractions, loss of consciousness, marked autonomic functions

Question 40

What is an atonic seizure?

Answer 40

Loss of postural tone, sagging of the head or falling, may loose consciousness

Question 41

What is a clonic seizures?

Answer 41

Rhythmic clonic contractions of all muscles, loss of consciousness and marked autonomic manifestations

Question 42

What is a myoclonic seizure?

Answer 42

Isolated clonic jerks associated with brief bursts of multiple spikes in EEG

Question 43

What is an infantile spasm?

Answer 43

Fragmented attacks that are usually bilateral, brief recurrent myoclonic jerks of the body w/ sudden flexion/extension of body and limbs

Question 44

Which type of seizure are you likely to see in early childhood?

Answer 44

Primary generalized