Week 4 Flashcards
(36 cards)
excessive activity begins in one specific area but can migrate to other areas
(epileptic seizure)
Focal seizures
Paroxysmal depolarising shift
neurons in focal area experience LARGE and long-lasting depolarisation followed by the firing of action potentials
- When this occurs, it usually maintains within a certain region > during seizures, due to
failure of inhibitory mechanisms, it spreads and widespread abnormalities in brain
function occur
Plotselinge de polarisatie start
excessive activity arise in widespread areas of the Brian all at once
- Underlying mechanisms are not generally understood
Generalised seizures
Pervasive hyper-excitability
which region(s)
neurons in the cortex and abnormalities in neural
networks between thalamus and cortex may be involved
Brein is te gevoelig en jumped naar elke neuron –> alleen bij generalized zoals tonic clonic
Epilepsy: the numbers
- ….. neurological disorder
- Approximately …. people with epilepsy in NL
- 1 in … are mentally disabled
- …% reasonably free of seizures with medication
Most common
90.000
1 in 3
70%
diagnosis of epilepsy
1 of 3 conditions:
At least two unprovoked (or reflex) seizures with >24 hours apart
One unprovoked (or reflex) seizure AND a probability of further seizures similar to the VERNAL RECURRENCE risk (>60%) after two unprovoked seizures, occuring over the NEXT 10 years.
hypoxia
Ischaemia
Is a deficiency in the amount of oxygen reaching the tissues
Is a shortage of blood flow to the brain
It leads to Periventricular leukomalacia PVL
PVLHI
When is the diagnoses of epilepsy considered ‘resolved’?
An age-dependent epilepsy
AND is past that age AND seizure free for the last 10 years without medication for 5 years
You can measure the epilepsy with
3 things
EEG
Heteroanamnesis
Clinical observation
classification 3 steps
Seizure classification, then;
Epilepsy classification, then;
Epilepsy syndrome classification
Can be motor or non-motor and secondary generalised
Seizure Epilepsy classification
Focal onset
Involves both hemispheres and always causes a loss of awareness CAN include motor and non - motor
Generalised onset
Phases of the seizure (3)
Pre-ictal: hours, days ahead (person can feel the upcoming seizure –> aura)
Ictal: occurence of the seizure
Post-ictal: recovery period
Comborbidity with epilepsy
ADHD, Autism, Anxiety, ODD, Depression and Psychoses
People with epilepsy have …. scores in comparison to population (learning)
1/3 lower scores
(no specific learning problems)
People with epilepsy compared to those who are chronically ill
3
people with epilepsy stay behind more in class
AND need more specific learning attention
AND show more ups and downs
most often where cognition rises when seizures are not as prominent and vice versa
Scattered
reach maximum potential earlier, and remain on the same level
Leveling out
Deteriorate
decline in cognitive functioning
People with epilepsy have a …. development
Delayed development: stay behind, but are still going forwards
Behavioural problems with people who have epilepsy (3)
Direct effects of seizures
pre-ictal, ictal post-ictal
- Fear as part of the seizure (often in temporal epilepsy) NOT due to fear of symptoms
- Behaviour changes in pre-ictal period (1-3 days before)
- Depressed or anxious mood in the post-ictal period (24h after)
Cognitive problems (direct effects of epileptic seizure)
- Concentration difficulties
- Missing information
- Complaints about memory
Indirect effect of seizures (epilepsy)
- Low self esteem
- Learned helplessness
- Limited independence
- External locus of control
- Vulnerable to stress
- Anxiety disorders and depression
- Loss of social activities Language difficulties
Indirect effect of seizures
EXTERNAL factors
External factors
- Environmental fear: parents overprotective
- Too much protection, or too little due to not wanting to keep fighting with your teenager to
prevent them from doing dangerous things
- Coping mechanisms of parents
- Stigmatisation
