Seizure Disorders 2
Terms
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- Define seizure.
- A seizure is a state of pathologic hypersyncrhonous behavior of a large number of neurons associated with altered neurologic function; an episode of abnormally synchronized and high-frequency firing of neurons that results in abnormal bheavior or experience of the individual
- Define epilepsy.
- a condition in which there is a tendency to have recurrent unprovoked seizures (about a 1-2% incidence)
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Lifetime risk of having a single seizure is:
a) 1-2%
b) 5-10%
c) 10-15%
d) 15-20% - Lifetime risk of having a single seizure is 10-15% of the population
- True or False? Epilepsy is the 3rd most common neurological disorder in adulthood?
- False. Epilepsy is the 4th most common neurological disorder in adulthood and is the MOST common neurological condition in childhood (4.3-9.3/1000)
- True or False? Onset of epilepsy most commonly occurs during the early 20's.
- False. Onset of epilepsy most commonly occurs during childhood and adolescence.
- True or False. The incidence of epilepsy is higher among prison inmates than in the general population.
- True. There is a high incidence of epilepsy in prisons (approximately 4x the general population). reduced impulse control + lower SES = criminal behavior
- What is kindling?
- Kindling refers to the susceptibility to electrophysiologic dysfunction in the area in the contralateral hemisphere homologus to the original site of discharge.
- A brief simple partial seizure that is experienced by the patient with no outward behavioral manifestation is called an ___.
- A brief simple partial seizure that is experienced by the patient with no outward behavioral manifestation is called an AURA. They may occur in isolation, or they may serve as a warning for a larger seizure, when patients have seizures that typically begin in one region of the brain before spreading.
- What are some symptoms (auras) patients might report when they are experiencing seizures arising from medial temporal limbic structures.
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1) a visceral sensation of rising in the epigastric area
2) feeling of deja vu
3) strange unpleasant odors
4) feelings of extreme fear and panic - True or False? Auras that include odors and/or panic are thought to arise from the hippocampus.
- False, Odors and panic are thought to arise from the amygdala and nearby cortex, rather than the hippocampus
- This type of EEG pattern is the normal dominant/background activity over the occipital region and is about 8-13 CPS/hertz.
- Alpha
- This type of EEG pattern slows in elderly and in nearly every brain-based neurological illness.
- Alpha
- This type of EEG pattern is prominent with concentration, anxiety, and under the effects of minor tranquilizers.
- Beta
- This type of EEG pattern is lost with eye opening, falling asleep, and medication that affects mental function.
- Alpha
- Presence of this type of EEG pattern is detected in children and everyone entering deep sleep, but is generally absent in healthy alert adults.
- Theta/Delta
- This type of EEG pattern lies over the frontal lobes.
- Beta
- This type of EEG pattern may indicate a degenerative illness or metabolic derangement if observed in a generally health adult
- Theta/Delta
- This type of EEG pattern is > 13 hertz.
- Beta
- This type of EEG pattern often slows in the elderly, and in the early stages of Alzheimer's disease.
- Alpha
- This type of EEG pattern ranges from 4-7 hertz.
- Theta
- This type of EEG pattern ranges from 1-3 hertz.
- Delta
- A focal presence of this type of EEG pattern may suggest a lesion in that region.
- Theta/Delta
- True or False? EEG is useful to detect or exclude structural lesions.
- False, EEG is NOT helpful in detecting or excluding structural lesions.
- These type of waves are present on EEG in metabolic/toxic encephalopathy and hepatic/renal failure delirium.
- triphasic waves
- these types of waves are often present in subacute sclerosing parencephalitis and CJD and are often seen as myclonic jerks.
- periodic complexes
- True or False. EEG is not useful in differentiating locked-in syndrome and persistent vegetative state.
- False. EEG is useful in differentiating locked-in syndrome and persistent vegetative state (slow and disorganized)
- If an EEG is conducted following ECT, what is often observed?
- EEG s/p ECT often looks post-ictal (similar to GTC seizure), and slow wave activity may continue for 3 months.