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26 Cards in this Set

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  • Back
Define seizure.
A symptom of a dz caused by the imbalance of excitation and inhibition in the brain.
What happens to hippocampal cells after repeated seizures?
Neurons die in the hippocampus and sprout outside the dentate entagling the hippocampus with excitatory inputs. These develop into an excitatory positive feedback mechanism transforming the hippocampus and temporal lobe into an epileptic center.
What commonly is causal stimulus for epipleptic seizures?
1. Focal irratation of interconnected cells
2. Genetic abnormalities (such as channelopathies)
What is a PDS?
Paroxysmal depolarizing shift typically observed spontaneously in epileptic injured cells. Because of the connectivity of the brain a PDS in one/group of cells can excite an exponential amount resulting in instability ti excitation and inhibition.
What is the most common form of epilepsy? General of Focal?
Characterize absence epilepsy.
1. Staring spell in 5-6year old children
2. Characteris 3Hz spike&wave on EEG
Similar to Juvenille Myoclonic Epilepsy
Characterize Juvenille Myoclonic Epilepsy.
1. Similar presentaton as absence epilepsy except:
1. Juvenille rather then childhood onset
2. Have myoclonic convulsions (lightning jerks)
4. Females affected > Males
Define Symptomatic, Idiopathic & Cryptogenic classifications of epilepsy.
1. Symptomatic mean known cause
2. Idiopathic means no known cause
3. crypotgenic cause uknown, but it is presumed that there is a cause
Characteize West Syndrome.
Age of onst 3-7mos. with chaotic background EEG with spasm progresses to Lennox-Gastaut if pt lives betweem 1-8. occuring with mltpl seizures, mental retardation and 1-2Hz EEG waves. Patients also have atonic epilepsy which lead to head injuries hence the helmet
List non-epileptic events that mime epilepsy.
1. Cardiac syncope
2. TIA
What is a clonic seizure?
A seizure in which the body is experiencing involuntary repetitive jerks
Describe a Simple Partial Seizure.
simple (complete conservation of consciousness), Partial-only effects on part of the brain (ex: tingling in hand or Dejavu)
Describe a Complex Partial Seizure.
1. present similar to simple partial except there is an alteration of consciousness (hence complex) usually localizing to the temporal/frontal aspects of the brain.
(ex: not able to speak or understand what is going on around you)
Define a Generalized seizure and list some examples.
Seizure with distribution over the head in to both hemispheres consisting of tonic (stiffening) and clonic (jerking) seizures, postictal state w/o focal deficits.
**may begin as partial
Characterize three symptomatic focal seizures.
Temporal- nod, deja vu, complex partial seizures
Frontal- Bizarre behaviors, nocturnal seizures
Parietal-sensory and function impairment
What is the first line treatment for Partial Seizures?
Sodium Channel blockers:
TEGRETOL & DILANTIN....treat the paroxysmal depolarization shift (PDS)
How would one treat absence seizures?
Ethosuximide Ca channel blocker
What is the clinical utility for phenobabrbitol?
Used in children under five for partial seizures. May inhibit cognition and learning.
How is status epilepticus treated?
Ativan (benzodiazipine Gaba Agonist)
How would one treat Myoclonic seizures?
Depakote or benzodiazipines
Define epilepsy.
A tendency toward recurrent seizures unprovoked by any systemic or acute neurologic insult. >90% are accquire less then 10% are genetic
What are some risks associated with taking antiseizure medications?
1. Low bown density
2. CYP450 Hepatic enzyme induced
3, hypermetabolism of Vit D and K, estrogen and testo
4.Implicated in contraceptive failure
When should one discontinue AEDs?
1. After 2 years of seizure freedom
2. **after failure of 2-3 drugs work up for surgery
What other treatments exist for epilepsy other then drugz?
1. Vagus Nerve Stimulation
2. Brain Surgery
3. Ketogenic Diet
True/False. 50% of epileptic patience have normal findings on MRI.
Define Status Epilepticus.
1. Continuous seizure of more then 30 min
2. Two or more sequential seizures without total recovery of consciousness