Wk.6 L3 - Epilepsy Flashcards
(12 cards)
LO
Define Epilepsy and Seizures:
- Understand the difference between a seizure and epilepsy.
- Identify the various types of seizures and their clinical manifestations.
- Classify Epileptic Seizures and Syndromes:
- Describe the classification of seizures (focal, generalized).
- Understand common epilepsy syndromes (e.g., focal epilepsy, generalized epilepsy, absence seizures). - Recognize the Risk Factors for Epilepsy:
- Identify common causes and triggers for seizures (e.g., head trauma, infections, stroke, genetics, brain tumors). - Understand the Pathophysiology of Epilepsy:
- Explain the basic neurophysiological mechanisms underlying seizure generation.
- Discuss the role of neuronal excitability and neurotransmitter imbalances (e.g., GABA, glutamate) in epilepsy. - Understand Epilepsy in Special Populations:
- Understand the impact of epilepsy on quality of life and the challenges in managing long-term care for patients with epilepsy –
see video link
Assessment and Application:
- Discuss key epilepsy-related topics in small group discussions or written assignments.
- Demonstrate a basic understanding of epilepsy’s clinical and scientific aspects in quizzes or exams
Epilepsy
- 4th most common neurological
- disorder
- Only 60-70% of patients on antiepileptic drug treatment are seizure free
- Results from surges of numerous uncontrolled electrical activity in the brain resulting in seizures
Comorbidities occur in severe cases:
- Movement dis.
- Speech impairement
- Intellectual disabilities
- Autism
- ADHD etc.
ILAE 2017 classification of seizure types
Focal onset:
- Very focused on one side of the brain and spreads
- Motor and non-motore onset, focal to bileteral, or tonic/clonic
Generalised onset:
- Starts accross whole brain
- Tonic/ clonic
- Abscent seixures
Unknown onset:
- Unclassified and undiagnosed
- non-motor
Electroencephalogram (EEG)
Seizure type can be differentiated and identified via electroencephalogram (EEG) seen as spikes and waves
Febrile seizures
Appear as generalised but is not necessarily epilepsy
Occur in children 1/30
No connection to epilepsy and damage to brain
Status Epilepticus
Can lead to death
Occurs when it is prolonged, where seizures occur in close bouts, and or the person doesn’t recover between seizures
Any type of seizure, can be convulsive or not
Considered a medical emergency and requires prompt medical attention
The longer a seizure lasts, the less likely it will resolve of its own accord, leading to brain damage and death
Epilepsy Syndromes
Depends where seizure is in brain, symptoms other than seizures will occur leading to epilepsy syndromes
Characterized by a set of clinical features,
signs, and symptoms that occur in addition to seizures and identified in infancy or early childhood
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Causes of epilepsy
70-80% of are due to genetics
- Genetic variation can include, missense, nonsense and frameshift mutations
Brain tumour, genetics, head injury, encephalitis, cystic fibrosis
Importance of genetic testing for epilepsy
May help identify the causes
May lead to an accurate diagnosis and management
Better inform family members of their own risk
Pathophysiology of epilepsy
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Trigger causes nerve cells to fire via action potential
‘Electrical hyperactivity of a storm’ within the brain
Excitatory and inhibitory neurotransmitters
Maintain brain homeostasis
Glutamate and GABA coexist to balance brain activity
GABA is an inhibitor or neuronal firing
- When released into synapse, binds to receprots and allows -ve ions to flow into the cell
- -ve charge causes activity to stop
Glutamate is excitatory
- When released into synapse, it binds to receptors to allow another action potential to start
Brain homeostasis is disrupted due to chemical imbalance
- When there is an imbalance in either direction, there are problems and chemical disruptions
- Less inhibition leads to epilepsy or even death
- Drugs work by increasing inhibition
- However too much inhibition can lead to epilepsy for unknown reasons
