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Epilepsy
neuro module 2
16
Medical
Professional
01/17/2010

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Term
seizure
Definition
transient disturbance of cerebral function caused by episodes of excessive and synchronous neuronal discharge within a network of neurons, which results from changes in excitatory or inhibitory receptors and imbalance between excitation and inhibition
Term
causes of neuronal overexcitation
Definition
1. increased action of excitatory neurotransmitters (glutamate and aspartate)
2. excessive depolarization currents induced in the ion channels of the neuronal membrane
Term
causes of neuronal disinhibition
Definition
1. defective hyperpolarizing currents (Cl- influx and/or K outflow)
2. decreased influence of inhibitory neurotransmitter (GABA)
Term
metabolic causes of seizure
Definition
1. hyponatremia
2. hypoglycemia
3. hyperosmolar states
4. hypoxia
5. hypocalcemia
6. hypomagnesia
7. renal or liver dysfunction
Term
drug withdrawals that cause seizures
Definition
1. alcohol withdrawal: 6-48 hrs after cessation
2. sedative withdrawal (barbiturates and benzodiazapines)
Term
drugs that cause seizures
Definition
isoniazid
antidepressants
antipsychotics
local anesthetics (caines)
penicillin
aminophylline
sympathomimetics
narcotic analgesics
phencyclidine
antihistamines
cyclosporin
Term
epilepsy
Definition
recurrent, unprovoked seizures that may be a primary condition or secondary to an underlying pathology such as stroke or tumor
Term
partial seizures
Definition
*begin locally
elementary symptomatology: without impairment of consciousness, can have motor, somatosensory, autonomic, or psychic symptoms, special sensory hallucinations

complex symptomatology: impairment of consciousness, temporal lobe or psychomotor seizures
Term
generalized seizures
Definition
bilaterally symmetrical without local onset
Term
ictus
Definition
sudden attack - refers to seizure
Term
post-ictal
Definition
1. period immediately following seizure
2. patient is sleepy and confused
3. usually lasts 5-15mins, can last hours
4. transietn focal deficits
5. EEG may show focal or generalized slowing
Term
aura
Definition
occurs before simple partial seizure; may serve as a warning of impending complex partial or secondarily generalized seizure
Term
automatism
Definition
coordinated repetitive, stereotyped, purposeless movements - may be simple or complex
Term
absence seizures
Definition
1. brief (5-10 secs) episodes of loss of consciousness without loss of postural tone
2. unresponsive, blank, cessation of ongoing activity
3. no post-ictal period
4. genetically transmitted
5. childhood to age 20
6. high seizure frequency
7. can be precipitated by hyperventilation and be associated with blinking
8. 50% have generalized tonic-clonic seizures
Term
tonic-clonic seizure
Definition
1. loss of consciousness
2. tonic contraction of muscles producing extension of extremities and arching of body
3. followed by clonic activity with symmetrical rhythmic synchronous jerking of limbs
4. tonic contraction of respiration muscles: loud cry, cyanosis
5. contraction of masticatory muscles: tongue biting
6. 30 secs-2mins
Term
status epilepticus
Definition
continuous seizure activity for more than 30 mins or 2 or more sequential seizures without full recovery of consciousness
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