YANG seizure biology

Question 1

Seizure

Answer 1

paroxysmal disorder of the CNS characterized by abnormal cerebral neuronal discharges with ot without loss of consciousness

Question 2

Epilepsy

Answer 2

repeated seizures due to damage, irritation, and/or chemical imbalance in the brain which leads to a sudden, excessive, synchronous electrical charge

Question 3

Pathophysiology of seizure disorders

Answer 3

result of disordered, synchronous, and rhythmic firing of a population of brain neurons (synchronized hyperexcitability)

during a seizure, the brain uses more energy that it can manufacture, and thus prolonged seizures can result in cell ischemia

Question 4

Focal onset

Answer 4

aware, impaired awareness

motor onset, nonmotor onset

focal to bilateral tonic-clonic

Question 5

Generalized onset

Answer 5

Motor: tonic-clonic, other motor

Nonmotor: absence

Question 6

Unknown onset

Answer 6

Motor: tonic-clonic, other motor

Nonmotor

Unclassified

Question 7

Focal seizures

Answer 7

60% of seizures

only part of the brain affected

begin focally in cortical region (temporal lobe)

usually due to a lesion, head trauma, stroke, hypoxia at birth, metabolic disorder, infection

focol to bilateral

Question 8

Generalized seizures

Answer 8

40% of seizures

loss of consciousness

both brain hemispheres involved

referred to as primary or idiopathic

genetic

Question 9

Pathways for the propagation of focal and generalized seizures

Answer 9

Seizure activity spreads from a focus in one part of the brain. This is a focal seizure

Focal seizures frequently progress to secondary generalized seizures via projections to the thalamus (focal to bilateral)

Primary generalized seizures propagate via diffuse interconnections between the thalamus and cortex. Involve both hemispheres of the brain.

Question 10

Focal and generalized seizures yield different EEG patterns

Answer 10

??

Question 11

Focal seizures can be the AWARE type (simple partial)

Answer 11

no loss of consciousness

25% of focal seizures

subjective experiences (auras) also occur

Question 12

Focal seizures can be of the aware type or involved IMPAIRED AWARENESS

Answer 12

Impaired awareness referred to ask complex partial

clouding of consciousness

repetitive motor behaviors

seizure followed by confusion, fatigue, throbbing headache

aura is common

postical state due to impaired awareness

Question 13

Postical state

Answer 13

after a seizure, a patient will not recover a normal level of consciousness immediately

may lasts for seconds to hours depending on: area of brain affected, length of seizure, AEDs, age

Symptoms: confusion, disorientation, anterograde amnesia

Question 14

Typical absence seizure

Answer 14

“petit-mal”

brief loss of consciousness

staring or eye flickering

abrupt

repetitive

no convulsions, aura, or postictal period

Question 15

Atypical absence seizure

Answer 15

slower onset

more difficult to control pharmacologically