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Exam 3
Lecture 1- seizure pathophys
70
Anthropology
11th Grade
10/15/2013

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Term
seizures are synchronus/asynchronus neuron firing
Definition
synchronus
Term
what seizures have motor activity invovleD?
Definition
convulsive
Term
the characteristic feature of seizures is-
Definition
abnromal brain electrical activity
Term
what type of seizure doesnt have the abnormal EEG?
Definition
psychogenic (PNES)
Term
what meds dont work for PNES seizures?
Definition
anti-convulsants
Term
what defines epilepsy
Definition
2 seizures not within 24 hrs
Term
some things that cna precipitate a seizure-3
Definition
infection, fever, alcohol withdrawl
Term
what genetic disease can predispose to seizures?
Definition
alzheimer;s
Term
what is the period of abnormnal electrical activity called?
Definition
ictus
Term
*periods outside of the ictus have abnoral acitivty its just less
Definition
Term
what seizure is only in one hemisphere?
Definition
Focal / partial
Term
which focal seizure has loss of consiousness
Definition
complex
Term
which seizure has an auro/premonition before it happens
Definition
complex partial
Term
if focal seizures go to a gnerealized seizure what is this called?
Definition
secondary generalized
Term
which type of seizure has jerks - fast burst of msucle acitvity
Definition
myoclonic
Term
which type of seizure has tremor- rhythmic contraction/relaxation
Definition
clonic
Term
whihc seizure has steady contraction of flexors and tensors?
what is a concern for these?
Definition
tonic
loss of balance
Term
what is the grand mal seizure?
Definition
tonic-clonic
Term
this seizure has sudden gain in muscle tone then rhythmic contraciotn/relaxation
Definition
tonic-clonic
Term
in tonic clonic seizures what happens to consciousness?
what are the worries?
Definition
pt is unaware of seizure
-loss of balance and physcial harm like tongue biting
Term
what seizure has rapid loss of muscle tone
-what happens?
Definition
atonic
-person falls down
Term
what is the petit mal seizure
Definition
absence
Term
what happens in a absence seizure?
Definition
pt loses consiousness but appears alert- is unresposnive
Term
what are automatisims?
which seizure do they occur in?
Definition
stereotyped behaviors
absence
Term
absence seizures are long/short
Definition
short
Term
the only difference btwn absence and complex partial seizures is?
Definition
absence doesnt have the premonition of the seizure occuring
Term
what is the post-ictal hangover?
Definition
person feels fatigued, disoriented
Term
what type of epilepsy invovles the hippocampus?
too mnay of these results in?
Definition
temporal lobe
scaring due to cell damage and microglial acitavtion
Term
if seizure doesnt terminiate in normal time its called?
what is this normally treated with?
Definition
staus epilepticus
BDZ
Term
in epileptic brain what does the EEG look like?
Definition
high amp spikes or wave
Term
since the seizures show hyperexcitatory this means the brain is depolarized, hyperpolarized?
Definition
depolarized
Term
during seizure what happens to Glu and GABA
Definition
Glu increases
GABA decreases
Term
where are GABA not found
Definition
nueromuscular junction
Term
GABA helps sharpen what tpye of signal?
Definition
lateral inhibtion
Term
what to GABA interneurons do?
Definition
prevent GLu from acitvating a whole tree of neurons
Term
if a GABA interneurons blocks the soma and axon hillock what is it doing?
Definition
blocks them from firing
Term
if GABA interneurons make synsapses on distal dendrites what does this doe?-2
Definition
blocks integration of signals and CA regulation
Term
in epilepsy the threshol for hyperexcitability is lower- what are causes? -4
Definition
GABA receptor downregulated
GABA subunit exchange
loss of GABA neurons in epilepsy
-down regulation of KCC2
Term
what GABA neurons are reduced in epilepsy?-2
Definition
somatostain and parvalbumin
Term
when is GABA excitiaory?
how?
Definition
immature neurons
-more hyperploarized than equilibrium for Cl (high intracell Cl)
Term
in GABA excitatory, what is missing that allows high intracell Cl? (this is normal for immature neruons tho!)
Definition
K/Cl cotransporter (KCC2)
Term
the common AEDs used target what?
Definition
voltage gated Na channels (prolong inactivation)
Term
what 2 drugs are good for absence but not other seizures?
Definition
ethosuximide
valproate
Term
the drugs that target absence seizures target what?
what switch does this flip?
Definition
T type Ca channel in thalmus (trnasient, dihydropyridine sensitive)
-tonic awake to phasic slow wave sleep
Term
what is the drugs that targets SV2A
Definition
levetiracetam
Term
what % of ppl are pharmcoresistant?
Definition
30%
Term
the big concern about anticonvulsant drugs are they cant prevent?
Definition
epilepsy pregression
Term
to be candidtate for surgery have to fail _ amount of AEDs
Definition
3
Term
implantable devices that cause what can be used to reduce seizures in pahrmcoresistn
Definition
vagal nerve stimulation
Term
ketogenic diet is high and low what
Definition
high fat
low carb
Term
the modified what diet is also used in adults for seizures?
Definition
Atkins
Term
keton bodies can elevate what in the brain?
(we dont knwo why this is helpful tho)
Definition
ATP
Term
ketogenic diet causes hypo/hyperglycemia?
why do you want this?
Definition
hypoglycemia
hyperglycemia actually increased seizure freq (so dont want as many carbs)
Term
what inhibitor of glycolysis has been used in animals to prevent siezures?
Definition
2-deoxyglucose
Term
the big concern with the ketogenic diet is?
Definition
hyperlipidemia
Term
to be a gentic etiology -
Definition
has to be previous idiopathic. (doesnt cause metab abnormality- directly causes the seizure!)
Term
structural/metabolic etiology has to be-
Definition
abnormality that increases the epilepsy risk
-genetics can cause the abnormality
Term
cryptogenic mean-
Definition
unknown cause
Term
genes involved in seizures
Definition
volt gated Na
K+ channels
Ca+ channels
synaptic transmission proteins (deleiton fo sV2A)
GABA
Glutamate
Term
mutation in what GABA caises childhood absence seizure
Definition
GABA- A recptor y2
Term
GLUT1 deficiency causes what that increases seizures?
how can this be treated?
Definition
decrease brain glucose
ketogenic diet
Term
Genes that cause juvenile myoclonic epilepsy
Definition
CACNB4- (N type Ca channel)
GABRA1- alpha 1 sub GABA
GABRD- delta subunit GABA
CLCN2- CL channel
Term
age of onset for juvenile myoclonic epilepsy
Definition
14-20
Term
Dravet syndrome is-
Definition
serve type of epilepsy that begins in childhood
Term
Dravet syndrome can cause what type of seizures-3
Definition
febrile
myoclonic
SE
Term
Dravet syndrome is caused by what mutation
Definition
alpha 1 subunit of volt gated Na channels
Term
*plasma metabolites are involved in seizures
Definition
Term
*autoantibodies have been found in some seizures
Definition
Term
structural causes of seizures-2
Definition
fetal alcoholism
head wound
Term
Lennox-Gastaut syndromre is caused by?
Definition
structural/metabolic abnormality
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