Lecture 45: Epilepsy Flashcards Preview

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Flashcards in Lecture 45: Epilepsy Deck (44):
1

Seizure

Uncontrolled release of electrical activity

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Epilepsy

Seizure disorder: two or more unprovoked seizures

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How often does a seizure have a found cause?

25%

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Kindling

Epilepsy isn't good for you, the more you have the more you get

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Main categories of epilepsy (2)

Primary Generalized; Focal/Partial

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Most generalized epilepsy has what cause?

Genetic

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Types of generalized epilepsy (6)

Absence, myoclonic, primary generalized tonic-clonic, tonic, clonic, atonic

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Focal epilepsy in two categories. Also categorized by...

Simple and complex; brain region (i.e. temporal)

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Reflex epilepsy

Triggered by stimuli (i.e. photosensitive by particular Hz)

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Epilepsy differential (7)

Syncope, cardiac arrhythmias, migraine, hypoglycemia, narcolepsy, panic attacks, psychogenic non-epileptic seizures

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What do you look for when testing epilepsy?

Lesion!

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Epileptic regions

Hippocampus, enterorhinal cortex and amygdala (medial temporal lobe)

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Why do you record EEG near the ear?

Amplifies EEG

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Delta

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Theta

4-8Hz

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Alpha

8-13Hz: awake, alert but relaxed, eye closed

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Beta

>13Hz: awake/alert in anterior head regions, large numbers associated w/ benzo use

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Epilepsy auras differ from migraine in that they...Can include (4)

Are part of (don't precede) seizure; sudden intense fear, deja/jamais vu, olfactory/gustatory hallucinations, visual/motor

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Frontal lobe seizures are common/rare. Only seizure that can be...Symptoms?

Fairly rare; bilateral w/out LOC; vocalizations, shaking, head turn

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Generalized tonic-clonic seizure: aura, length, consciousness, post-ictal state

Must be generalized from onset, no aura (no focal areas involved), LOC, 2-3 minutes, amnesia/confused after

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Tonic

Freeze

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Clonic

Moving

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Absence seizures. Another name?

Sudden behavioral arrest, staring/unresponsive, sudden return to normal w/out pre-event amnesia but doesn't recognize seizure; also called petit-mal seizures

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Absence/petit mal common trigger...describe. Common wave pattern?

Triggered by hyperventialation, regular generalized, 3/second spike and slow wave

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Absence seizures are common in?

Children

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Myoclonic seizure. Common trigger? Always epilepsy?

Brief, quick movements in body; light/startle; no

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Todd's post-ictal paralysis

Post-seizure paralysis due to seizure in motor region of the brain

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What is the most common abnormality underlying temporal lobe epilepsy?

Medial temporal sclerosis

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Describe temporal seizure symptoms

Epigastric rising feeling, intense fear, deja vu, olfactory hallucinations, automatisms (lip smacking)

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Frontal lobe seizures are common/rare. Only seizure that can be...Symptoms?

Fairly rare; bilateral w/out LOC; vocalizations, shaking, head turn

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Occipital lobe seizures are common/rare. Symptoms

Rare; poorly formed colored lights across visual field

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Juvenile myoclonic epilepsy; associated with? Prognosis?

Myoclonus early in day; positive family history; benign but may last for life

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Benign epilepsy with centrotemporal spikes (Rolandic seizure) symptoms. Prognosis?

Parethesiae involving mouth --> unilateral clonic activity of face; often occurs shortly after falling asleep; benign, resolve by adolescence

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Infantile spasms (West syndrome) age of onset, symptoms, prognosis. Treatment?

3-12 months of age; jerk followed by stiffening; NOT benign, associated w/ retardation; give high doses ACTH

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Lennox-Gaustat Syndrome triad. Prognosis?

Mental retardation, slow spike and wave, multiple seizure types; difficult to treat

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Atonic seizures are dangerous because?

Sudden loss of tone can lead to falling --> injury

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Febrile seizures definition and prognosis

Occurs w/ high fever in young child, less than 15 min; generally benign and don't require treatment

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Seizures are the _______ most common presentation of brain tumor

Second

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Drug treatment response rate and rules

70%; first try monotherapy: "start slow, increase slowly"

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How long seizure-free when medication will be often be stopped?

Three years

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Surgical treatment is primarily for...

Focal seizures

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Status Epilepticus definition

Condition w/ seizures lasting for more than 30 minutes or multiple seizures lasting 30 minutes w/out recovery

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Why is Status Eplipeticus serious

Death in 5-10% due to circulatory collapse

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Psychogenic Non-Epileptic seizures are associated with (3). What do they look like?

True seizure disorder, sexual abuse, bereavement; non-stereotyped thrusting, eyes closed, face not involved, feels normal afterward

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