Term
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Definition
| A paroxysmal event characterized by abnormal excessive and synchronized discharge of CNS (latin word meaning to take possession of) |
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Term
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Definition
| A condition charaterized by recurrent seizures cause by a chronic, underlying process. |
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Term
| What are the two types of epilepsy? |
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Definition
Primary: most common type, 0.5% of population, onset usually before the age of 20
Secondary: intracranial neoplasms, post-head trauma, post meningitis or encephalitis |
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Term
| What are the types of seizures? |
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Definition
Generalized seizures: tonic-clonic (grand mal), absence (petit mal), myoclonic and febrile
Partial Seizures: retain consciousness, simple: single muscle group/limb, complex: sensory hallucinations +/- motor |
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Term
| Describe a Tonic Clonic Seizure. |
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Definition
Loss of consciousness, rigidity, cessation of respiration, fall to the ground, occassionally preceded by an aura, tonic phase last < 1 minute, folllowed by a flaccid come, then post-ictal phase: where they regain consciousness.
In the post ictal phase, usually have a headache/confusion, fatigue, lethargy, malaise, many will desire sleep, muscle soreness, duration of the phase is several to many hours |
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Term
| Describe status epilepticus. |
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Definition
| Repetitive seizures, consciousness not regained between siezure or a seizure lastings > 5 minutes, represents a medical emergency (IV anticonvulsant treatment required) |
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Term
What is some anti-seizure strategies?
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Definition
| Enhance inhibitory CNS influences by increasing GABA NT activity, Reduce the excitatory CNS influences by decreasing the glutamate NT activity, and modulate ionic conductance. |
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Term
| Which generation of anti-seizure drugs is more effective? |
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Definition
| Neither! Both generations are equally effective, we aren't really sure which is really better! |
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Term
| What are 2 non-pharmacologic treatments? |
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Definition
| Neurosurgical excision of the lesion causing the foci to seizure. Or, VNS vagus nerve stimulation has seen to show improvement in partial seizure deterance. |
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Term
| What are some side effects from anti-seizure medication? |
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Definition
| Long duration of therapy means side effects of sedation, skin and bone marrow toxicity possible, drug interactions are also common, pregnancy requires consultation, and need to be aware of Abrupt withdrawal of treatment may cause frequent seizures, which could trigger status epilepticus (tappering off is a better approach) |
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Term
| What defines multiple sclerosis and how common is it? |
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Definition
350,000 Americans per year, women are outnumber men 2:1, most commonly begins in the 20-40 y/o range.
Characterized by areas of demyelination in the CNS, inflammatory damage (probably autoimmune), followed by gliosis (scarring), these lesions vary in time and location |
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Term
| Describe Relapsing-Remitting MS. |
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Definition
| Initial symptoms resovle or significantly improve over a span of weeks to months, intervals of months to years follows until new lesions develop which cause new symptoms, eventually the remissions after each attack are less complete and the patient experiences increasing disability |
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Term
| What is the difference between primary and secondary progressive MS? |
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Definition
Primary: Abrupt onset and steady progression, remissions are rare and incomplete
Secondary: after an initial relapsng remitting phase, the disease progrsses steadily |
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Term
What are some common MS symptoms?
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Definition
| Limb weakness, numbness or tingling, spasti paraparesis of various muscle groups, optic neuritis (vision loss), diplopia (double vision), loss of control of bladder or rectal sphincters, vertigo |
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Term
| What is the gold standard drug for treating MS? |
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Definition
| Interferon. Immunosuppressing antibody treatments are promising, but, costly and toxic to an extent. |
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Term
| What is the theory behind IVIG? |
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Definition
| Donor IgG may bind hot immunoglobulins, including abnormal ones, massive amount of IgG may trigger "purge" of Ig by complement, may block macrophage receptors and prevent them from becoming stimulated |
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Term
Which type of MS has the best prognosis and which has the worst?
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Definition
| Best is for relapsing-remitting, worst is for primary progressive....although both conditions are fatal. |
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Term
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Definition
| A progressive, irreversible decline in mental function affecting memory, reasoning, judgement, abstract thought, learning, and use of language |
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Term
What enhances the risk of dementia and what reduces it?
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Definition
Enhancers: age, female, head injury, chronic diseases, atherosclerosis and diabetes
Reducers: education and intellectual stimulation, social interation and physical exercise, medications: statins and NSAIDS |
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Term
| What is the most common cause of dementia? What is the second? |
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Definition
Most common = Alzheimer's disease
Second = Vascular dementia (multiple cerebral infarcts) |
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Term
| What can be used to prevention and treatment of dementia? |
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Definition
Prevention: Statins and non steroidal anti-inflammartory drugs
Treatment: AcH inhibitors, NMDA antagonists |
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Term
| Benign vs Malignent tumors, and Primary vs secondary. |
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Definition
Rate if growth (slow vs. rapid), infilitration of surrounding tissue, both can be fatal
secondary is much more common than primary, promary tumors are usually singel while secondary are usually multiple |
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Term
| what is the most common form of Gliomas? |
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Definition
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Term
| What are the different grades of astrocytomas? |
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Definition
low grade (I and II): most common in children
Intermediate (III)
High grade (IV): gliobastoma multiforme, most common in adults |
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Term
| What is a microadenoma vs a macroadenoma? |
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Definition
Micro: less than 10 mm in size, asymptematic unless they secrete a hormone
Macro: 10 or more mm, can impinge on the optic chiasma |
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Term
| What is a microadenoma vs a macroadenoma? |
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Definition
Micro: less than 10 mm in size, asymptematic unless they secrete a hormone
Macro: 10 or more mm, can impinge on the optic chiasma |
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Term
| How are pituitary tumor symptoms usually presented? |
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Definition
| Due to hormone secretion or through visual field defects. |
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Term
What are some primary CNS tumor symptoms?
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Definition
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Term
| Whats a new treatment option for tumors? |
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Definition
| Utilizes bioengineered polio virus |
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Term
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Definition
| A benign and recurring syndrome of headache associated with other symptoms of neurologic dysfunction. Occurs in females more than males. |
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Term
| What is prodrome? What is Aura? |
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Definition
Prodome: symptoms that occurs hours or days before the headache onset, in cludes mood changes, food cravings, stiff neck etc.
Aura: symptoms minutes before the headache, visual scintillations, sensory pins and needles, motor hemiplegic weakness. |
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Term
| Who is the most suseptable to cluster headaches? |
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Definition
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Term
| What is a useful agent for cluster headaches? |
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Definition
| Supplemental oxygen is often useful!!! |
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