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Terms in this set (43)
What disorder is characterized by uncontrolled excessive activity of either part or all of the CNS?
What is another name for epilepsy?
When does an epileptic attack happen?
When the basal level of excitability rises above a certain critical threshold.
What are the 3 classifications of epilepsy?
1- Grand mal epilepsy
2- Petit mal epilepsy
3- Focal epilepsy
Is epilepsy a common neurological disorder?
What is the incidence of epilepsy in new cases per year?
125,00 to 180,000 new cases per year
What is the total annual epilepsy-associated costs?
What age does epilepsy occur at?
What are the 8 major affects of a grand mal epilepsy episode?
1- Loss of consciousness
2- Fall or Cry
3- Muscular rigidity (tonic)
4- Rhythmic jerking (clonic)
5- Respiration inhibited (cyanosis occurs)
6- Tongue bite (incontinence) injury can occur
7- Usually lasts 1-3 minutes
8- Post-seizure depression, stupor, fatigue, and sleepiness
How long does the tonic phase last in a grand mal epileptic episode?
What is another name for grand mal epilepsy?
Generalized tonic clonic seizure
What is involved in the clonic phase of a grand mal epileptic episode, and what does this induce on the body?
Its a flexion, extension, tremor lasting for about 30 seconds and causes brief, violent, flexor spasms of the whole body
What are the 6 things that usually follow postictal CNS depression due to a grand mal epileptic episode?
1- Autonomic changes
2- Increased heart rate, blood pressure, and bladder pressure
3- Pupillary mydriasis
4- Skin cyanotic
5- Glandular hypersecretion
6- Brief apnea
What parts of the brain are affected by extreme neuronal discharges in grand mal epilepsy?
All areas of the brain, especially;
2- Deeper parts of the cerebrum
3- The brain stem
Discharges are transmitted all the way to what structure below the brain in grand mal epilepsy?
The spinal cord
Is a grand mal epileptic episode usually unilateral or bilateral?
Bilateral (involves both sides of the cerebral hemispheres simultaneously)
What are the 7 major inducers of Grand mal attack?
1- Genetic predisposition (1-50 to 100 people)
2- Strong emotional stimuli
5- Loud noises
6- Flashing lights
7- Brain trauma
What are the 2 things that stop Grand mal attack?
1- Neuronal fatigue
2- Active inhibition by inhibitory neurons that have been activated by the attack
What is another name for petit mal epilepsy?
What part of the brain does petit mal epilepsy involve?
Thalmocortical brain activating system
How long does a patient become unconscious for suffering from petit mal epilepsy?
What happens to the head and neck muscles and the eyes in a person suffering from petit mal epilepsy petit mal epilepsy?
Contraction of the head and neck muscles and blinking of the eyes
What type of pattern is seen on an EEG due to oscillation of inhibitory and excitatory thalamocortical neurons in petit mal epilepsy?
Spike and dome patterns
What is the onset age of petit mal epilepsy and when does it usually disappear?
Onset = 5-10 years
Disappears by the age of 30
Is there any postictal confusion after a petit mal epileptic attack?
Where are clonic jerks seen in patients with petit mal epilepsy?
What are the 4 things that focal epilepsy result from?
1- Scar tissue in the brain
2- Brain tumor
3- Destroyed area of the brain tissue
4- Congenitally deranged local circuitry
What type of focal epilepsy is marked by motor seizures with unilateral clonic movements that start in one muscle group and spread systematically to adjacent groups, reflecting the march of epileptic activity through the motor cortex?
Psychomotor epilepsy is a type of focal epilepsy that can cause what 4 things?
1- Short period of amnesia
2- Attack of abnormal rage
3- Sudden anxiety, discomfort or fear
4- A moment of incoherent speech
What parts of the brain does psychomotor epilepsy involve?
The limbic system:
4- Portion of the temporal cortex
What is the definition of status epilepticus?
When 2 or more seizures without recovery of consciousness in between
What are the 3 types of status epilepticus?
1- Generalized convulsive
3- Simple partial
How long do single status epilepticus seizures last for?
Greater then 20-30 minutes
Keeping a person away from dangerous situations, speaking quietly and reassuringly, and using restraint only if necessary are first aid precautions to what type of seizure?
Grand mal epilepsy
When should a physician or ambulance be called in order to manage a seizure?
1- Seizures last more than 5 minutes
2- Patient has recurrent seizures
3- Patient dose not begin to regain consciousness soon after seizure
4- Patient has major injuries from the seizure
5- First seizure experienced by the patient
Open head injury produced by bullets or shrapnel is associated with what percentage of chance for developing epilepsy?
What chance does closed head trauma, such as after an automobile accident or blunt injury carry a chance of epilepsy?
5% or less
What factors predispose the development of epilepsy after head trauma?
1- seizure within 2 weeks of injury
2- Depressed skull fracture
3- Loss of consciousness for longer than 24 hours
4- Cerebral contusion
5- Subdural hematoma
6- Subarachnoid blood
7- Above the age of 65
What hormone tends to decrease cortical excitability, lowering the seizure threshold, and increases the intericital spike frequency?
A rise in what hormone just before ovulation can increase the chance of epilepsy in mid-cycle?
What are the 2 major treatments of epilepsy?
1- Antiepileptic drugs
The choice of antiepileptic drugs usually depends upon what factors?
1- Type of seizure/epileptic syndrome
2- Potential side effects
3- Frequency of dosing
4- Comorbid conditions
5- Drug interactions
7- Cost of the drug
What should sexually active and fertile women with epilepsy take on a daily basis to prevent neural tube defects caused by some anti-epileptic drugs?
Folate (folic acid) (1-5 mg/day)
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