Neurodevelopment  Epilepsy

Epilepsy and Neuro Developent
Biofeedback, Neurofeedback and Epilepsy - What is the difference between a seizure and epilepsy? - A seizure is a single event while epilepsy is chronic unavoidable seizures.
What is required to diagnose epilepsy or seizure? - EEG
How do you classify seizures? Based on what? - Origin on the seizure
What are the three different types of seizures and how are they different? - 1. Symptomatic -known lesion, tumor or bleed causing problem

2. Cryptogenic -Known area of activity but the specific cause and specific location not known

3. Idiopathic -unknown location due to genetic disorder or ion channel problem
What is the most important characteristic for physicians dealing with seizures to define? - Whether the seizure is focal or generalized.
What type of seizure is more easily treated? - Focal
Define a focal seizure. - Localized to a small area or only one hemisphere - Limited behavioral changes
Define a general seizure. - Bilateral, symmetric behavioral responses
Can an individual sense when a focal seizure is going to spread into a generalized seizure and warn you? - Yes
Do you have cortical function during a generalized seizure? - No cortical function
What type of onset do you have with a generalized seizure? - Sudden
Do you have conscious behavior with a generalized seizure? - No
What are six types of generalized seizures? - 1. Grand mal (tonic/clonic)
2. Absence
3. Febrile seizures
4. Myoclonic
5. Atonic
6. Tonic
Does a febrile seizure predispose you to epileptic seizures later in life? - No only atypical febrile seizures do.
What type of onset is seen with partial seizures? - A slower entry into the seizure.
What are the characteristics of a simple partial seizure? - Slow onset with some unusual motor movements. Remain conscious throughout the seizure. One can also respond to commands throughout the seizure.
What are the characteristics of a complex partial seizure? - the patient is conscious but unresponsive to commands. One also has some asymmetric senseless motor sx.
Which seizure is described as being "motor bizarre behaviors and beliefs, brief and nocturnal"? - Frontal lobe seizure
Which seizure is described as "fear, loss of consciousness, deja vu, amnesia and automatisms"? - Temporal lobe seizure
Which seizure is described as "somatosensory derrangements, diziness"? - Parietal lobe seizure
Which seizure is described as "visual changes"? - Occiptal lobe seizure
What can one use to determine where a seizure originates and then spreads to? - Ictal semiology
What property of the affected tissue allows one to determine if a seizure happened there? - the tissue is metabolically inactive.
What indicates a tendency or a history of seizures? - Interictal spikes
A seizure may be a warning for what? - Some other major underlying disorder.
In the ER, what two types of tests should be done on someone suspected of having a seizure? - MRI and EEG
What percentage of seizure patients that Dr. P sees do not have epilepsy? - 30%
Why would you want to be absolutely sure one has epilepsy before you subscribe epileptic drugs? - They are neurotoxic
Seizures are relatively common up until what age? - 5
Why are seizures common in the elderly age group? - Falls, tumors, ect
Why are seizures common in ages up until 5? - Metabolic disorders and trauma
What determines treatment options? - Type of seizure
What is the ultimate goal of seizure treatment? - No seizures with no side-effects
How many drugs are used to begin with when treating seizures? - 1
Can one develop drug resistance? - Yes
Of the four major seizure drugs, which has the best quantitative effect? - They all are the same -47%
What happens to effectiveness as you piggyback meds? - They only add a little bit more of a positive effect.
Name six alternative options when drug therapy is not working. - 1. Exp drug therapy
2. Ketogenic diet
3. Resective surgery
4. Vagal nerve stimulator
5. Implantable cortical stimulator
6. Disconnection procedure
How long (technically) until you consider a seizure status epilepticus? - 30 minutes
How long in a medical setting (not technically) before you consider a seizure status epilepticus? - 5 minutes
What is the first thing you treat SE with? - IV benzodiazepines or rectal valium
If unresponsive to the first SE reponse, what do you treat with? - IV anticonvulsants
If you cannot resolve SE by drugs (first two responses), what is the next step? - Induce comas for 24 hour intervals until the seizure subsides.
If one has an epileptic seizure, how long until they are allowed to drive again (AL)? - 6 months
What are the effects of seizure drugs on pregnancy? - Reduced fertility and they are teratogenic; also complicate pregnancy
Does progesterone promote or supress seizures? - Supress
Does estrogen promote or supress seizures? - Promote
What age group are generalized seizures more common in? - Children
What is the most common seizure type? - Partial seizure
Name five characteristics of absence seizures. - 1. Abrupt onset
2. Generalized 3Hz wave spike
3. Frontal lobe
4. Brief duration
5. Rapid return to baseline
Epilepsy Neurodevelopment 2017