Pcol Sem 2 Test 4 Antiepilepsy

Front 1

what infections can lead to epilepsy

Back 1

encephalitis, meningitis

Front 2

what is epilepsy

Back 2

reccurent seizures unprovoked by insults

Front 3

what is the seizure focus

Back 3

area in cortex that functions as an abnormal pacemaker

Front 4

what are the possible changes observed in the seizure focus

Back 4

morphological
metabolic
pathologic

Front 5

what are the morphological changes to seizure focus

Back 5

gliosis (increase astrocytes)
decreased neuronal density (less neurons)
abnormal nerve structure
decrease density of inhibitory synapse

Front 6

what are the metabolic changes

Back 6

increase cerebral blood flow
increase metabolic rate
increase lipid metabolism

Front 7

what are the pathologic changes

Back 7

decrease inhibitory control (less gaba)
increase excitability (more glutamate)
decrease Na/K ATPase activity (ionic balance not well maintained)
adenosine deficiency (decrease adenosise more excitability)
abnormal channel expression

Front 8

what is a sequence of events that converts a normal neuronal network to a hyperexcitable network

Back 8

epileptogenesis

Front 9

what are the classes of glutamate Rc

Back 9

ionotropic [fast] (NMDA, AMPA, Kainate) MAJOR DRUG TARGET

metabotropic [slow] (GPCR, modulatory)

Front 10

what GABA rc is postsynaptic

Back 10

GABAa

GABAb is post synaptic coupled to G proteins and increase K current

Front 11

what GABA Rc is presynaptic

Back 11

GABAb

postsynaptic coupled to G proteins to increase K current

Front 12

what does GABAb do

Back 12

autoreceptor that reduces NT release by decreasing Ca influx

Front 13

what happenes when EXCITATION occurs

Back 13

increase inward flow of Na and Ca
increased glutamate

Front 14

what happens when INHIBITION occurs

Back 14

decrease inward Cl and outward K
decreased GABA

Front 15

what type of seizures start and spread in both sides of the brain

Back 15

generalized seizures

Front 16

what type of seizures do you ALWAYS lose conciousness

Back 16

generalized

Front 17

what are the types of generalized seizures

Back 17

tonic-clonic (grand mal)
absence (petit mal)
myoclonic
status epilepticus

Front 18

what occurs in tonic clonic (grand mal) seizures

Back 18

sudden stiffness (tonic phase) followed by jerking motions (clonic phase)

Front 19

what type of seizure do you see an increase in saliva and loss of bladder control

Back 19

tonic clonic

Front 20

what type of seizure is Febrile seizures and why is it not classified as epilepsy

Back 20

they are tonic clonic seizures that occur in children

not classified as epilepsy b/c they are due to sickness (fever)

Front 21

what seizure is mistaken for day dreaming

Back 21

absence seizure (petite mal)

see a brief loss of consciousness

Front 22

who are absence seizures often seen in

Back 22

young children

Front 23

what is seen in myoclonic seizures

Back 23

muscle contractions
see jerk in one or two limbs or in the head

seizure is so brief that although the person loses consciousness they still appear concious

Front 24

what occurs in status epilepticus seizures

Back 24

continuous (10mins) ongoing series of seizures that may be fatal

2 OR MORE sequential seizures w/o full recovery in between

Front 25

what drugs are given to treat tonic clonic seizures

Back 25

valproate
carbomazepam
phenytoin

Front 26

what drugs can be given to treat absence seizures

Back 26

valproate
Ethosuximide

Front 27

what drugs can be given to treat status epilepticus

Back 27

diazepam

Front 28

what seizures start on one side of the brain/body and may cause a loss of conciousness

Back 28

partial seizures

Front 29

what drugs are given to treat partial seizures

Back 29

carbamazepam
valproate
clonazepam
phenytoin

Front 30

what occurs in simple partial seizures

Back 30

starts in one side of the brain
patient remains conscious

Front 31

what are secondary generalized seizures

Back 31

partial seizures that are initially localized then spread to both sides of the brain

Front 32

what type of seizure will the pt know the seizure is coming but lose consciousness once it spread to both hemispheres

Back 32

secondary generalized

see auras before onset

Front 33

what are complex partial seizures

Back 33

start in one part of the brain and can spread to areas involving consciousness

Front 34

what is a characteristic of comples partial seizures

Back 34

tugging on clothes

patient is not aware of their actions

Front 35

what is used to diagnose epilepsy

Back 35

medical history
physical exam
EEG
neuroimaging

Front 36

what is the significant of performing physical exams and checking medical history

Back 36

sometimes epilepsy is due to insults such as a pt having a history of head trauma or alcoholism which can cause epileptic symptoms

Front 37

what does the EEG do

Back 37

measures electrical activity in the brain and is used for diagnosis

Front 38

what is neuroimaging used for

Back 38

identifies potential causes of seizures

CT, MRI

Front 39

what are the models of epilepsy

Back 39

animal model
phamacological approaches
kindling
kainate

Front 40

what is an example of the pharmacological approaches used in epilepsy

Back 40

aluminum oxide, penicillin crystals are depolarizing compounds and increase excitability

pentylentetrazole (convulsant drug) is a GABA antagonist and will decrease GABA therefore increasing excitability

Front 41

what is kindling

Back 41

placement of electrodes to cause seizures

Front 42

what is kainate

Back 42

glutamate Rc agonist that causes spontaneous seizures