Lecture 12 Flashcards
(11 cards)
Epilepsy
4th most common neurological disorder in the world, affecting 1% of population. ~60-70% patients on antiepileptic drug treatments are seizure free. Comorbidities occur in severe cases incl. movement disorders, speech impairment, intellectual disabilities, autism, ADHD, gut/sleep issues and more. Arises from surges of uncontrolled electrical activity in brain causing seizures. Each patient is unique and type follows international guidlines. When seizure occurs, influences motor, language and visual cortex and how it influences rest of the body.
Focal onset
starts on one side of brain and spreads. May be aware of environment or that they are having seizure
Generalised onset
Across whole brain. Tonic-clonic motor or non-motor or unclassified affects
Seizure presentation on EEG
Seizure types can be determined by EEG which looks at brain activity. Focal seizures have spikes and waves on i side of the brain and the other is normal. While generalised onset has spikes and waves on both sides
Febril seizures
Appear as generalised seizures but is not epilepsy. Common in children 6months-6years. May be viral, fever, red/blue face, eye rolling, loss of consciousness, muscle jerk. Only epilepsy if genetically linked or always begins with temp. increase.
Status epileptius
Severe form of epilepsy that can lead to death. Prolonged seizure in close bouts and person doesn’t recover between seizures. Any type of seizure and can be convulsive or not. Medical emergencies as the longer a seizure lasts, decrease likely it resolves on its own. Risks long-term brain damage
Origin
Location alters other symptoms (not seizures) to occur leading to distinct epilepsy syndrome. They are characterised by a set of clinical features, signs and symptoms that occur in addition to seizures identified in infancy or early childhood.
Causes of epilepsy
70-80% due to genetics (inherited or spontaneous). Incl. missense, nonesense and frameshift mutations. Also, head injury, stroke/brain tumour, drugs/meds/autism
Importance of genetic testing for epilepsy
Helps identify the cause of a person’s epilepsy. Leads to accurate diagnosis and personalised care. Helps caregivers understand disease. Family can make informed decision about pregnancy and their own risk, understand the appropriateness of medicine on their types.
Pathophysiology
AP generates -> Decrease in inhibitory or increase in excitatory or abnormalities in ion channels or inflammation -> Rhythmic and repetitive hyper-synchronous discharge of neurons -> seizures -> epilepsy when regular occurence or seizures
Neurotransmitters maintain brain homeostasis
GABA and glutamate balance between brain activity. GABA release binds to GABA(A) receptors causing chloride to flow into cells, dampening activity (inhibitory). Glutamate is excitatory triggering AP. Evidence that increases inhibition also leads to epilepsy.
