patho test 4

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tab
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186986
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patho test 4
Updated:
2012-12-03 23:58:08
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epilepsy seizures
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epilepsy and seizures
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  1. an episode of abnormally synchronized and high-frequency firing of neurons in the brain that results in abnormal behavior or experience of the individual
    seizure
  2. at least 2 unprovoked seizures separated by at least 24 hours
    epilepsy
  3. spontaneous recurrent seizures due to genetic or acquired CNS damage
    epileptic seizures
  4. process by which the brain develops epilepsy,
    triggered seizures can lead to neuronal damage that, itself, can lead to the development of chronic epilepsy
    epileptogenesis
  5. seizure from touching a power supply as an example
    seizure expression
  6. involuntary contractions of voluntary muscles, sometimes violent contractions
    convulsion
  7. seizure where patients my sit and stare, or blink
    absence
  8. seizures with automatisms - peeing in the fridge
    complex partial
  9. pertains to the seizure itself
    ictal
  10. period between seizures (can be minutes, hours, days, months)
    inter-ictal
  11. period shortly after a seizure (can be seconds, minutes, hours)
    post-ictal
  12. sustained muscle contraction & the high-frequency, synchronous neuronal firing that drives it
    tonic
  13. brief, intermittent muscle contractions & the bursts of synchronous neuronal firing that drives it
    clonic
  14. cumulative incidence of epilepsy
    3% lifetime risk of having a seizure
  15. risk of epilepsy within 5 years of severe head injury
    15%
  16. incidence - 2 peak ages for epilepsy
    • 1st - early years
    • 2nd - late in life (strokes)
  17. incidence of a 1st seizure 40-59 and 60 and older
    • 55/100000
    • 127/100000
  18. percent of poorly treated epilepsy's by AED
    25-30
  19. main cause of seizures
    idiopathic 70%
  20. main seizure of birth to 1st year
    myoclonic > partial > GTCS >absence
  21. main seizure of 2nd year
    partial > GTCS > absence > myoclonic
  22. main seizure of 30th to 60th year
    partial > GTCS > myoclonic > absence
  23. main seizure of 80th year
    partial > GTCS > myoclonic > absence
  24. seizures that arise secondarily to local or systemic disturbances. once the disturbance is corrected the seizures do not recur
    non-epileptic seizures
  25. occurrence of multiple consecutive seizures without intervals of consciousness
    status epilepticus
  26. initiation phase of a seizure
    • synaptic
    • altered balance between excitation & inhibition
    • increase glutamatergic or decrease GABAnergic
  27. propagation phase of seizure
    • synaptic - calcium channels & glutamatergic receptors
    • intrinsic - sodium and/or potassium channels
    • non-synaptic - gap junctions, ephaptic effects
  28. post-ictal phase of seizures
    • prolonged obtunded state after some partial & GTCS
    •    
  29. interictal phase of a seizure
    • pts can be completely normal between seizures
    • in "partial" seizures, especially; brief bursts of synchronous activity (interictal spikes)
  30. localization-related or focal seizure
    partial
  31. bilateral seizure
    generalized
  32. partial seizure where consciousness is preserved
    simple
  33. parial seizure with an impairment of consciousness
    complex
  34. partial seizure that spreads bilaterally
    secondarily generalized
  35. 3 examples of generalized seizures
    • absence
    •    typical
    •    atypical
    • myoclonic
    • tonic-clonic
  36. childhood absence epilepsy
    pyknolepsy
  37. two types of seuzures with childhood onset and may be self limiting
    • absence
    • febrile
  38. type of seizure with adolescence onset
    myoclonic (juvenile myoclonic epilepsy (JME))
  39. type of seizure that can have and early onset but varies
    generalized tonic-clonic
  40. type of seizure where the onset is due to some type of insult (toxin) or too-rapid AED withdrawal
    abnormally prolonged seizure or the pt. does not fully regain consciousness between seizures
    seizure lasting longer than 5-10 minutes
    status epilepticus
  41. type of absence seizure with
       abrupt onset/termination
       rapid return to normal consciousness
       posture usually maintained
    typical
  42. type of absence seizure with
       more pronounced changes in tone
       EEG more heterogenous
       more AED resistance
    atypical
  43. type of seizure that
       most commo in childred
       can remit later in life
       neuropathology not usually present
       thalamocortical circuit 3 Hz
       triggered spontaneously
          flashing lights or patterns
    absence
  44. generalized absence seizures occur at what channels
    T-type
  45. what seizures have a 3 per second, fire silence sequence
    general absence
  46. what type of siezures are asians more prone to
    febrile
  47. prevelance of 3-8% in 0-7 yo
    most common seizure disorder
    not "true epilepsy"
    febrile
  48. at what stage of a fever does the seizure usually occur
    the rising phase
  49. is a simple or complex febrile seizure more common
    simple
  50. type of seizure with
       sudden, brief shock-like contractions
       may occur around sleep onset or awakening
       may occur with other seizure types
    myoclonic
  51. this is what people think of when they think "seizure" of convulsive; the patient is moving limbs repeatedly
    old term - grand mal seizure
    tonic-clonic
  52. 3 seizure symptoms characterize what type
       myoclonic jerks
       GTCS
       sometimes absence
    juvenile myoclonic epilepsy (JME)
  53. what drug is useful in JME and why
    valproate - broad acting
  54. previously known as "impulsive petite mal"
    JME
  55. JME is often caused by this: when the neurons don't migrate where they need to be
    microdysgenesia
  56. aura with rising abdominal sensation, fear, unreality, deja vu
    temporal
  57. aura with electrical sensation, tingling or numbness
    parietal
  58. aura with visual changes such as colored lines, spots, shapes or even vision loss
    occipital
  59. how long do you treat a status epilepticus seizure
    until EEG shows no seizures

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