Epilepsy/Seizures

Question 1

Seizure

Answer 1

Brief, sudden, excessive discharge of electrical activity in the brain
Provoked, unprovoked, or PNES

Question 2

Provoked seizure

Answer 2

Direct cause such as: head injury, non-epileptic infection, drugs)

Question 3

Unprovoked seizure

Answer 3

Epileptic
Does not have an immediate cause

Question 4

Psychogenic non-epileptic seizures (PNES)

Answer 4

Resemble seizures, but no abnormal brain electrical activity
Caused by psychological stress

Question 5

Seizure classifications

Answer 5

Focal
Generalized

Question 6

Focal

Answer 6

Onset is localized to a specific region of the brain
Simple: don’t impair consciousness
Complex: alter consciousness

Question 7

Generalized

Answer 7

Thought to involve both hemispheres
“Grand-mal” seizures (generalized tonic-clonic)

Question 8

Grand-mal seizures

Answer 8

Tonic extension of extremities and trunk (around 20 sec)
Clonic synchronous rhythmic muscle movements (around 45 sec)

Question 9

Seizure diagnostic measure

Answer 9

EEG

Question 10

EEG

Answer 10

Measures brain electrical activity to identify seizures
Poor sensitivity but high specificity

Question 11

Epilepsy

Answer 11

At least 2 unprovoked seizures 24 hours apart
Can start at young age or adulthood
All types of seizures

Question 12

When first seizure activity is in adulthood, it is often associated with?

Answer 12

PNES

Question 13

Treatments

Answer 13

Medication
Surgery

Question 14

Medications

Answer 14

Anti-epileptic drugs (around 70% effective)
Side effects: cognition and mood changes
After 3+ don’t work, likelihood of controlling seizures through medicine is low (intractable/refractory epilepsy)

Question 15

Surgeries

Answer 15

Resection - remove source of seizures
Disconnection - disrupt pathways allowing seizures to spread
Implantation of medicine devices (vagal nerve stimulator or deep brain stimulation