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Flashcards in Epilepsy CC1 Deck (66):
1

partial (focal) seizure involves

1 hemisphere

2

generalized (global) seizure involves

both hemispheres

3

simple partial means

1. no LOC

2. single hemisphere

4

complex partial means

1. impairment of conciousness, but can still be awake

2. single hemisphere

5

secondarily generalized means

starts partial, then becomes generalized

6

where do generalzied seizures start?

in subcortical structures

7

abscense seizures involve

loss of consciousness without motor
symptoms. 

8

tonic generlized seizures involves

sustained contraction of muscles

9

clonic seizures involve

repetitive movements (like shaking)

10

tonic clonic seizures involve

start as tonic, then become clonic

11

atonic seizures involve 

negative sx, loss of muscle tone

12

how do you distinguish between complex partial seizure and abscence seizure?

eeg

13

subtypes of generalized seizures

1. abscence

2. tonic

3. clonic

4. tonic-clonic

5. atonic

14

what is epilepsy

the enduring predisposition to generate epileptic seizures

15

idiotpathic seizures are usually

genetic

16

what can cause epileptic channelopathies

mutations in voltage gated ion channels, can cause gain or loss of function

17

what is the inheritance pattern of channelpathies?

what kind of mutations are they mostly?

most are autonosomal dominant

mostly de novo

18

when do febrile seizures occur 

occurring in childhood after 1 month of age

19

what are febrile seizures associated with?

associated with a febrile illness not caused by CNS infection

no hx of previous seizures & not acutely symptomatic

20

febrile seizure is a ___ channelopathy

Na 1.1

21

Generalized Epilepsy with Febrile Seizures Plus invovles mutations in

 SCN1B or SCN1A

22

with Generalized Epilepsy with Febrile Seizures Plus you get a loss of

loss of fast inactivation --> Na channel gain
of function --> persistent Na current

23

with Severe Myoclonic Epilepsy of Infancy  you get a loss of 

 loss of high frequency action potential --> loss of inhibitory
function of GABAergic cortical interneurons & Pukinje cells --> seizures & ataxia

24

signs of Severe Myoclonic Epilepsy of Infancy in first year?

seizures associated with high body temp (fever, bathing) -->
seizures get progressively prolonged and cluster

25

what are the signs of  Severe Myoclonic Epilepsy of Infancy?

show psychomotor delay, ataxia, cognitive impairment

26

what is the range of severity of Na 1.1 channelpathies? 

A image thumb
27

sx of Benign Familial Neonatal Convulsion

brief generalized and partial seizures that usual resolve by age 6 weeks

28

K Channelopathies in Epilepsy invovles loss of function of what receptor?

Loss of Function from mutations in Kv7.2 and Kv7.3

29

K Channelopathies in Epilepsy involve gain of function from 

mutation in the pore-forming subunit 

30

KCNMA1) encodes

the pore formiung suybunit involved in generalized epilepsy & paroxysmal dyskinesia

31

what does loss of K poreforming subunit result in?

--> increased K flux --> generalized epilepsy & paroxysmal dyskinesia

32

Ca and Cl Channelopathies in Epilepsy Both can lead to 

idiopathic generalized epilepsy

33

Mutations in CLCN2 -->  results in

↓ Cl gradient, less GABAergic hyperpolarization

34

Antiepileptic drugs decrease the ___ of neurons

hyper-excitability

35

2 mechanism in which antielipetic drugs work? 

1. block Na channels
2. increase inhibitory neurons via GABA

36

wjhat regulates the function of Na and Ca channels?

B subuniots

A image thumb
37

describe the general structure of Na and Ca channels

6 membrane spanning regions x 4

A image thumb
38

describe the general structure of K+ channels

6,2,4,7 membrane spanning regions

39

with a seizure...

abnormal excessive and synchornous electrical discharges of brain neuronal network leads to

paroxysmal events characterized by clinical signs or sx

40

ictal refers to

seizure period or events due to seizure

41

aura is ictal or preictal?

ictal

42

prodrome is precital or ictal?

preictal

43

variations of simple partial seizures?

with:

1. motor signs

2. with somatosensory sx

3. ANS sx

4. psychic sx

44

ILAE classification divides seizure into

idiopathic, symptomatic, cryptogenic

45

first division of ILAE classification is?

second division?

first -- localization vs. generalized

second -- idiopathic, cryptogenic, etc

46

where are Na 1.1 and Na 1.3 found

in cell bodies

47

where are Na 1.2 found

unmyelinated axons and dendrites

48

where are Na 1.6 found

myelinated axons and dendrites

49

what leads to ataxia with SMEI?

loss of high frequency ap --> loss of inhibitory gaba purkinje cells

50

what is the pathophysiology of seizures with SMEI?

loss of high frequency AP ---> loss of inhibiotry function of gabaeric cortical interneurons --> seizures

51

to tx SMEI you have to reestablish

gabergic transmission

52

two drugs for SMEI?

tiagabine (dec gaba reuptake)

benzos (inc response of post synaptic gaba)

53

how do benzos work for SMEI?

inc response of post synaptic gaba

54

how does tiagabine work for SMEI?

dec reuptake of GABA

55

 SCN mutations (causing Febrile plus) are usually ___ mutations

missense

56

tx of febrile plus involves

antipletpic meds that potentially bind tommutant channels and stabilize folding of proteins

57

mutations in Na 1.1 causing febrile seizures usually results in what two things?

1. reudction of peak na current

2. positive shift in voltage dependece of activation

58

K channelpathies mostly invovle cells with __ current

M current (close to resting ptoential and is regualted by msucarnic and other g protein)

59

disorder assocaited with decreased m current

benigin familar neonatal convulsion

60

describe Cl channels

12 transmembrane segments

61

mutations in the CLCN2 gene can lead to

idiopathic generalzied epilepsy

62

result of gain of function of Ca channels

excessive snchonous rhytmic burst firing --> idiopathic generalized epilepsy

63

t type ca channels are notable because they

ave rhythmic burst firing 

64

are all seizures channelopathies?

no!

65

surgery should be considered in ___ epilepsy

localization realted epilepsy that does not respond to 2 medications

66

how do AEDS stabilize or block Na channels

they prolong the inactive states