Lecture 13: Epilepsy

T/F: seizure = epilepsy

false

convulsion

a sudden, violent-looking, irregular movement of a limb or of the body, caused by involuntary contraction of muscles

behavioral description of what’s happening in the body

convulsion

seizure

a sudden (symptom that caused by) uncontrolled electrical disturbance in the brain

symptom of hypersynchronous electrical brain activity

seizure

normally, neurons fire ___

at their own rate

in a seizure, neurons fire ___

at the same time

what happens to neurons if seizure activity continues

new neuronal connections can form (sped-up long term potentiation)

long term potentiation (LTP)

as neurons fire repeatedly due to experience, changes in the structure of those synaptic connections make it more likely they will fire again

T/F: seizures will always cause convulsions

false

epilepsy

a neurological disorder that is a predisposition to recurrent unprovoked seizures

conditions of frequency and timing for seizures to count as epilepsy

2 unprovoked seizures more than 24 hours apart

what is it called if seizures occur less than 24 hours apart

a singular event

T/F: all convulsions are seizures

false

T/F: convulsions are common presentation of seizures

true

T/F: seizure = epilepsy

false

T/F: convulsions are one of many presentations of seizures

true

T/F: all epilepsies have brain lesions

false

T/F: convulsions due to seizures are only one presentation of epilepsy

true

tonic

hypertense state; stiffness

clonic

jerking, convulsing

hallmark sign of a seizure

tongue-biting, especially lateral biting

what does it mean for lateral tongue-biting to have 100% specificity in relation to seizures

100% of people who show tongue biting have a seizure

what does it mean for tongue-biting to have a sensitivity of 24% in relation to seizures

24% of people who have a seizure show tongue biting

endogenous causes

internal, therefore unprovoked

exogenous causes

external, therefore provoked

epilepsy has provoked or unprovoked (answer w/ exogenous or endogenous)

endogenous

common examples of exogenous causes of seizures

medicines, drugs

common examples of endogenous causes

lack of sleep, stress, menstrual cycle

T/F: people with epilepsy/people prone to seizures show normal bursts of activity when not having a seizure

false

which brain imaging method may show up as normal for someone who is prone to seizures

MRI

which brain imaging method may show up as abnormal for someone who is prone to seizures

EEG

all types of epilepsies

partial/focal (simple, complex), generalized, mixed

what causes partial/focal epilepsies

focal lesions or other abnormalities (scarring, genetics, etc)

which type of epilepsy responds well to certain medications

partial/focal

which type of epilepsy may benefit from surgery to remove the affected area

partial/focal

what type of seizure does not respond well to medicines

temporal lobe epilepsy

which type of epilepsy affects the entire brain

generalized

which type of epilepsy crosses the corpus callosum

generalized

which type of epilepsy is typically caused by a genetic issue

generalized

which type of epilepsy can get worse with certain medications

generalized

which type of epilepsy starts focally then spreads throughout the entire brain

mixed

types of partial/focal epilepsies

simple, complex

simple partial/focal epilepsy

consciousness is not affected

complex partial/focal epilepsy

consciousness is affected

what does it mean for consciousness to be affected in epilepsy

abnormal thoughts, confusion, unconsciousness

tonic-clonic seizure other name

grand mal

how long is a grand mal seizure usually

2-5 minutes

status epilepticus

more than 5-10 minutes

typical signs of the tonic stage of a seizure

stiffening of body and limbs, back arched, fall down

typical signs of the clonic stage of a seizure

jerking of limbs, body, and head

first stage in a grand mal seizure

tonic

second stage in a grand mal seizure

clonic

third stage in a grand mal seizure

post-ictal

typical signs of the post-ictal stage of a seizure

limbs and body limp, weakness

absence seizure other name

petit mal

T/F: there is tonic activity in a petit mal seizure

false

T/F: there is a lack of clonic activity in a petit mal seizure

true

what happens in an absence seizure

person briefly blanks out without any awareness that this is happening

length of absence seizure

few seconds-3 min

signs of a petit mal seizure

vacant stare, eyes roll up, lack of response

atonic

muscle tone loss

signs of an atonic seizure

collapsing in a puddle of weakness

myoclonic

brief, sudden jerk

signs of a myoclonic seizure

sudden jerks, but not collapsing/shaking

most common type of partial seizure

temporal lobe epilepsy

two phases in pre-ictal stage

prodrome, aura

prodrome stage

period leading up to a seizure, characterized by feeling weird, different, uneasy, etc

how long is prodrome stage

hours-days

aura stage

knowing the seizure is coming

how long is aura stage

seconds

ictal stage

seizure

length of ictal stage

a few minutespo

length of post-ictal stage

ambiguous

post-ictal stage

time between the last seizure and the next one

how do we know what symptoms will occur in partial/focal seizures

depends on where in the brain the seizure is occurring

symptoms of a simple seizure occurring in the occipital lobe

visual: flashing lights, blurring

symptoms of a simple seizure occurring in the temporal lobe

auditory: ringing sounds

symptoms of a simple seizure occurring in the somatosensory areas

tingling of body parts

which type has stronger reactions/symptoms: partial or complex

complex

symptoms of a complex seizure occurring in the temporal lobe

auditory: hallucinations (music, voices)

symptoms of a complex seizure occurring in the occipital

visual: hallucinations (seeing things that are not there)

symptoms of a simple/complex seizure occurring in the olfactory areas

smelling things

macropsia

seeing things much larger than they actually are

micropsia

seeing things much smaller than they actually are

symptoms of a complex seizure occurring in the anterior cingulate cortex

complex behaviors: buttoning/unbuttoning clothes, snapping fingers

symptoms of a complex seizure occurring in the insula

butterfly feeling: nervousness

symptoms of a complex seizure occurring in the amygdala

fear

TLE occurs in the

medial temporal lobes

one symptom of TLE

amnesia

why does TLE cause amnesia

it affects the temporal lobe, where memory has high associations

one symptom of TLE

deja vu

one symptom of TLE

jamais vu

personality during inter-ictal period

emotionality (feeling feelings more strongly), attention problem, lack of confidence

personality during inter-ictal period of TLE

paranoia, philosophical interest, hyper morality, religiosity, obsession, sense of guilt, circumstantiality, hypergraphia

three factors that cause convulsions or seizures but not epilepsy

metabolic, infectious, immune

idiopathic meaning

unknown

three factors that cause epilepsy

structural, genetic, idiopathic

partial epilepsy causal factors

structural or genetic

T/F: epilepsy is only associated with one cause

false