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27 Cards in this Set
- Front
- Back
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What are some excitatoryNTs?
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Gutamate & Aspartate
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What are some inhibitory NTs?
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GABA & Glycine
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What causesburst firing? Where does it occur?
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Repetitive activation of action potentials. Occurs in the hippo
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What type of receptors play an important role in the spread of epileptic activity?
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NMDA receptors
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Where do recurrent excitatory pathways occur?
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In the hippo & neocortex via pyramidal collaterals
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What usually governs recurrent excitatory pathways?
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Widespread inhibitory circuits
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What part of the brain has anatomy that promotes epileptogenesis?
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Hippo
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What type of pathology is common in temporal lobe epilepsy?
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Hippo sclerosis
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What inc excitatory input b/w neurons in hippo sclerosis?
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Synaptic reorganization & inc axonal collateralization
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What does high frequency synaptic transmission cause?
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Inc accumulationof Ca near the presynaptic terminal.
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What does high freq synaptic transmission result in?
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1) Facillitation (inc glutamate release) 2) Potentiation (enhanced synaptic activity)
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How does repetitive neuronal firing affect synaptic activity?
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Depresses inhibitory synaptic activity
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How are neurons electrically coupled?
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Via gap junction & ephatic transmission due to close apposition membranes allowing direct propagation of seizure discharge
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Where does electrical coupling occur?
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In areas w/denselypacked neurons (hippo)
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What is epilepsy?
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Recurrent seizures produced by abnormal repetitive neuronal firing
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Describe neonatal seizures.
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Partial. Hypotonia, staring spells w/ slight jerking. Slow feeder & poor sucking
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Describe infantile spasms.
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"Shaken baby". Flexor extension spasms, in clusters, hypsarhrythmia pattern, onset birth to 2 yrs, peak @ 5-6 mths, most develop retardation & epilepsy for life
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Describe Lennox-Gastaut syndrome.
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Early childhood onset, manu etiologies, multiple seizure types, injuries from falls, mental retardation, slow spike/wave (2hz)
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Describe atonic seizures.
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abrupt onset, no warning, injuries common, difficult to treat, may respond to VNS, corpus callostomy may prevent falls
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Describe simple partial seizures.
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Focal onset, aura is common, remains conscious, may 2nd generalize (then lose consciousness)
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What characterizes tuberous sclerosis?
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ashleaf spots, hamartomas, intractable seizures w/ episodesof confusion & disorientation
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Describe complex partial seizues.
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Aura (ictal onset), alters consciousness, automatismsm postictal confusion, may 2nd generalize
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Describe benign focal epilepsy of childhood.
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Centrotemporal (Rolandic) or occipital spikes, nocturnal seizures, infreq, grows out of it by 16 yo
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Describe absence seizures.
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Brief stare, unresponsive, eye flutter, automatisms, sudden onset, arrest activity, no aura or postictal confusion, generalized 3 per sec spike/wave, most resolve w/ age, 20% will have convulsive seizures
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Describe generalized convulsive seizures.
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Abrupt onset, incontinence, postictal confusion, generalized spike/wave, tonic, clonic, tonic-clonic, or clonic-tonic-clonic
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Describe myclonic seizures.
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Sudden single jerks, single or in clusters, remain conscious, may pregress to clonic-tonic-clonic, generalized mulitspike wave
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Describe generalized myoclonic epilepsy.
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onset late in childhood, may develop into generalized convulsive or absence seizures, autosomal dominant (chrom 6)
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