Flashcards in Quiz 2 epilepsy Deck (43)
most susceptible areas of the brain to epileptic activity
frontal (particularly limbic) and temporal lobes
in a generalized seizure, the trigger is outside the cortex in the......
reticular formation or thalamus
general seizure presentation
- initial tonic rigidity with extensors overpowering flexors
- stop breathing, air expelled through closed glottis
- clonic phase - contraction relaxation
- postictal phase - relaxation
autonomic overflow can occur during seizure causing
emptying of bladder and to a lesser extent bowels
vitals during ictal phase of generalized seizure
- pupils dilated
- HR and pulse elevated
what is seen on the EEG during the clonic phase?
what do the spikes and waves represent in spike-wave EEG?
- spike - massive depolarization and muscle contraction
- wave - relaxation and massive neuronal inhibition
how can we distinguish between a primary generalized seizure and one coming from a focal seizure?
- when coming from focal seizure, there can be an aura or unusual motor events before seizure
discuss progression of juvenile myoclonic epilepsy (JME)
- starts in childhood with absence seizures
- late childhood/adolescence - involuntary jerking in the morning
- eventually has generalized seizure which leads to diagnosis
underlying cause of JME
- genetic mutations that affect ion channels
- at least six variations
a generalized seizure is also known as a
grand mal seizure
treatment of JME
- respond well to specific anticonvulsants
examples of metabolic grand mal seizures
- sedative withdrawal
when do absence seizures occur?
an absence seizure is also known as a
petit mal seizure
absence seizure presentation
- blank staring
- does not remember
- may be eyelid fluttering or chewing movements
petit mal diagnosis markers
- spike wave of 3 per second
- can almost always be brought on by hyperventilation
when focal seizure involves sensory cortex it usually presents as...
- positive symptom (presence of sensation)
hallmark of "complex partial seizures"
- more complicated emotions, feelings or perceptions
- clouding of consciousness
what is Todd Paralysis?
- focal paralysis due to post-ictal depression of function in area affected by seizure
- can be difficult to distinguish from a stroke
explain characteristics of focal seizure in motor area
- contralateral clonic jerks
- if it spreads, jerks spread to adjacent areas
- jacksonian march
presentation if focal seizure in somatosensory cortex
- contralateral paresthesia
- can also "march"
what is on the differential for simple partial seizure of the somatosensory cortex?
- migraine transient dysfunction
giveaways of TIA over simple partial seizure
- old age
- artery stenosis
- no "march"
- history of cardiovascular disease
giveaways for migraine over simple partial seizure
- followed by unilateral headache (but headache CAN come after seizure on rare occasions)
"march" of migraine vs simple partial seizure
- migraine - minutes
- seizure - seconds
presentation of auditory-vestibular partial seizure
- tinnitus (hallucination of sound)
auditory-vestibular seizure can be mistake for.... if no convulsion occurs
- inner ear disease (Meniere syndrome)
audiometric tests in AV-seizure
- normal in seizure
- abnormal in Meniere syndrome