Week 5 - Epilepsy

Question 1

What are the 3 generalsied seizures?

Answer 1

• Typical absence
  
  • No aura, brief
• Myoclonic
  
  • Sudden, arm jerking, brief
• Tonic-clonic
  
  • Sudden, 3 phases, headache after

Question 2

What are the 3 phasses of a tonic-clonic seizure?

Answer 2

• Tonic phase with cyanosis
• Clonic phase
• Post-ictal phase

Question 3

What is a generalise seizure?

Answer 3

One that simultaneously starts in both hemispheres

Question 4

What is a focal seizure?

Answer 4

• Starts in focus then spreads
• Aura then loss of awareness
• Simple partial or complex partial (loss of consciousness)
• Temporal lobe seizure
• Aura

Question 5

What is idiopathic epilepsy?

Answer 5

• No brain lesions
• No intellectual impairment
• Generalised seizures
• Controlled

Question 6

What is symptomatic epilepsy?

Answer 6

• Lesion in brain or brain disorder
• Cognitive problems
• Abnormal MRI
• Uncontrolled seizures

Question 7

What are the 3 causes of seizures?

Answer 7

• Neuronal over-excitement
• Epileptiform discharges
• Epileptogenesis

Question 8

What happens during neuronal over-excitement?

Answer 8

• Non-gated ion channels
• Voltage-gated ion channels
• Glutamate excites neurons
• GABA inhibits neurons

Question 9

What happens during epileptiform discharges?

Answer 9

• Neuronal bursting
  
  • Seizure initiation
• Synaptic effects
• Glia effects
• Non-synaptic effects
  
  • Seizure termination

Question 10

What happens during epileptogenesis?

Answer 10

• Damage of brain leading to epilepsy
• Structural changes
• Molecular changes
• Functional changes

Question 11

What happens during maximal electroshock seizure test?

Answer 11

• Application of electrical stimulus
• End-point = generalised tonic-clonic
• Test for anti-seizure activity against GTCs

Question 12

How was PTZ tested on mice?

Answer 12

• Subcutaneous injection of convulsive dose
• Observe for clonic seizure
• Test for anti-seizure activity against nonconvulsice seizures

Question 13

What is the importance of sodium channels in anti-epileptic drugs?

Answer 13

• The target for AEDs
• Some epilepsy caused by sodium channel mutation
• Mutation = gain or loss of channel function
• Some AEDs promote channel inhibition
• Some reduce GABA degradation or reuptake

Question 14

What drugs worsen absence seizures and myoclonus seizures?

Answer 14

Carbamazepine / phenytoin

Question 15

What are the main drugs used to treat epilepsy?

Any contraindications?

Answer 15

Valproate (facial deformaties if taken during pregnancy)

Levetiracetam

Benzodiazepines

Lamotrigine