epilepsy 1

Question 1

What is epilepsy?

Answer 1

chronic neurological condition affecting the brain

characterised by a tendency to have recurrent, unprovoked epileptic seizures

unprovoked by any immediately identifiable cause

Question 2

What happens during a seizure?

Answer 2

sudden surge of electrical activity in the brain caused by excessive discharge of neurons in gray matter and involuntary change in behaviour/how a person feels for short period of time

spontaneous and unprovoked

Question 3

another name for a seizure

Answer 3

ictus

Question 4

people with higher rates of epilepsy

Answer 4

infants
elderly
less wealthy

Question 5

co-morbidities

Answer 5

depression
anxiety
suicidal ideation
cognitive dysfunction
migraine
trauma

Question 6

social and econimic limitationf of epilepsy

Answer 6

stigma - social exclusion and discrimination
driving restrictions
employment restrictions

Question 7

mortality from epilepsy

Answer 7

x2-3 premature death

increased incidence of suicide

SUDEP most common form of death

Question 8

SUDEP

Answer 8

sudden unexpected death in epilepsy

Question 9

What happens during a seizure?

Answer 9

abnormal hyper-synchronous electrical activity of neuronal networks

too many brain cells becoms excited at same time

generates ‘electrival storm’ in brian

Question 10

What is epileptogenesis?

Answer 10

process where normal brain tissue is functionally transformed into tissue capable of generating recurrent, spontaneous seizures

Question 11

theories of epilepsy

Answer 11

1. imbalance in inhibitory/excitatory neurotramsmission

2. abnormality of neural connectivity

Question 12

Theory 1: disruption of normal balance between excitation and inhibition in the brain

Answer 12

too much excitation in epilepsy

• inc inward Na and Ca currents
• inc glutamate and aspartate NTs

to little inhibition

• dec inward Cl and outward K
• dec GABA NT

Question 13

Theory 2: abnormality in neural connectivity

Answer 13

greater spread and abnormal neuronal recruitment by oscillatory networks

due to

• enhances excitatory transmission
• failure of inhibitory mechanisms
• enhanced inter-neuronal connectivity
• changes in intrinsic neuronal properties

Question 14

2 classes of epilepsy

Answer 14

1. no obvious identifiable cause - idiopathic/primary epilepsy, genetic origin
2. obvious identifiable cause - symptomatic/secondary epilepsy

Question 15

causes of symptomatic epilepsy

Answer 15

brain injuries/CNS diseases:

• head injuries/birth traumas
• congenital abnormalities
• brain tumours
• stroke
• neurodegenerative diseases
• infections -> meningitis, encephalitis

Question 16

4 phases of an epileptic seizure

Answer 16

1. pre-ictal/prodrome
2. ictal
3. post-ictal
4. inter-ictal

Question 17

pre-ictal phase of seizure

Answer 17

before the seizure

mins-days
feel/act differently - aura
-> see/smell/hear/taste something for no reason, stomach, ringing in ears

Question 18

ictal phase of a seizure

Answer 18

period of the seizure

physical, sensory, psychic changes

Question 19

post-ictal phase of a seizure

Answer 19

immediately after seizure

mins-hrs
weakness, tiredness, confudion, Todd’s paralysis, somnolence

Question 20

inter-ictal phase of a seizure

Answer 20

period between seizures

may get emotional disturbances - fear, anxiety, apprehension

Question 21

classification of seizures ILAE 1981

Answer 21

BASED ON ONSET LOCATION
primary generalised seizures
- begin in both cerebral hemispheres

partial/focal seizures (simple/complex)
- begin in lodcalised area in 1 hemisphere

secondarily generalised seizures

• start off as partial/focal seizure (aura)
• spread to entire brain

Question 22

6 types of generalised seizures

Answer 22

absence (petit mal)

tonic-clonic (grand mal)

myoclonic

clonic

tonic

atonic