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Epileptic seizure is a health condition characterized by uncontrolled jerking movement and finally a momentary loss of self-awareness. It is caused by excessive neuronal activity in the brain. Gauge what you know on the types of epileptic seizures below.
Questions and Answers
1.
Which syndrome occurs in children, and is defined by 1) multiple
seizure types, 2) abnormal EEG (such as spike-and-wave discharge), and
3) impaired cognitive function in most cases?
Explanation Lennox-Gestaut Syndrome (LGS) is a syndrome that occurs in children and is characterized by multiple seizure types, abnormal EEG patterns such as spike-and-wave discharge, and impaired cognitive function in most cases. This syndrome is often diagnosed based on these three criteria and can have a significant impact on a child's development and cognitive abilities.
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2.
What is the primary difference in the classification of partial and generalized seizures?
Explanation Partial seizures are restricted to discrete areas of the cerebral cortex. General seizures involve diffuse regions of the brain simultaneously.
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3.
This type of seizure is characterized by sudden, brief lapses of
consciousness without loss of postural control. It typically lasts for a
few seconds and consciousness returns with no confusion. The seizures
usually begin in childhood or early adolescence.
Explanation Absence Seizures, also known as Petit Mal Seizures
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4.
This type of seizure is characterized by sudden loss of postural muscle tone lasting 1-2 seconds.
Explanation Atonic seizures are a type of seizure characterized by a sudden loss of postural muscle tone. During these seizures, the affected person may experience a brief moment of muscle weakness or limpness, causing them to suddenly collapse or drop their head. These seizures typically last for 1-2 seconds and can occur multiple times a day. Atonic seizures are often associated with epilepsy and can be potentially dangerous, as the person is at risk of falling and injuring themselves during an episode.
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5.
Kate is an 18 month old baby who began showing symptoms of otis media
this morning. While the mother tried to console Kate by rocking her she
noticed an increase in Kate's body temperature. Kate suddenly loses
conciousness and goes into convulsions. The convulsions stop after a
brief moment and the mother calls the doctor. What type of seizure did
Kate most likely experience?
Explanation Since Kate is over one year old, recurrence is less likely so she most likely experienced a simple febrile seizure.
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6.
These are nonepileptic behaviors that resemble seizures. They are
often part of a conversion reaction precipitated by underlying
psychological distress.
Explanation Psychogenic seizures refer to nonepileptic behaviors that mimic seizures. These seizures are not caused by abnormal electrical activity in the brain but rather by psychological distress. They are often a manifestation of a conversion reaction, which occurs when emotional or psychological distress is converted into physical symptoms. These seizures can be triggered by underlying psychological issues and are not related to epilepsy.
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7.
Seizures are a result of a shift in balance of what in the CNS?
Explanation Seizures occur when there is an abnormal shift in the balance of excitation and inhibition in the central nervous system (CNS). The CNS relies on a delicate balance between excitatory and inhibitory signals to function properly. When this balance is disrupted, there is an excessive buildup of excitatory signals or a decrease in inhibitory signals, leading to hyperactivity in the brain and the occurrence of seizures. Therefore, the correct answer is "Normal Balance of excitation and inhibition, excitation and inhibition."
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8.
Disruption to
inhibitory mechanisms by alterations in ion channels, damage or injury
to inhibitory neurons and synapses can allow for the development of a
seizure focus. Most inhibitory mechanisms are in the form of inhibitory
neurons and would utilize this particular neurotransmitter at their
synapse to discharge excitatory neurons.
Explanation Most inhibitory synapses in inhibitory neurons would utilize the neurotransmitter GABA.
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9.
These three features:1. Jacksonian March2. Todd's paralysis and3. epilepsia partialis continuaare characteristic for which kind of seizure?
Explanation The given features, Jacksonian March, Todd's paralysis, and epilepsia partialis continua, are all characteristic of Simple Partial Motor Seizure. Jacksonian March refers to the sequential involvement of different body parts during a seizure. Todd's paralysis is a temporary weakness or paralysis that occurs after a seizure. Epilepsia partialis continua is a condition where there are continuous, repetitive, and localized muscle jerks or contractions. These features collectively indicate a Simple Partial Motor Seizure.
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10.
This type of seizure involves a brief and sudden muscle contraction
in one part of the body and sometimes the entire body. The most common
occurances are at the onset of sleep. This type of seizure usually
coexists with other forms of generalized seizure disorders.
Explanation A myoclonic seizure is characterized by a brief and sudden muscle contraction in one part of the body or sometimes the entire body. These seizures often occur at the onset of sleep. It is also mentioned that this type of seizure usually coexists with other forms of generalized seizure disorders. Therefore, based on the given information, the correct answer is Myoclonic Seizure.
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11.
___________________________ are usually associated with diffuse or
multifocal structural abnormalities of the brain and therefore may
accompany other signs of neurologic dysfunction such as mental
retardation.
Explanation Atypical absence seizures are typically linked to diffuse or multifocal structural abnormalities in the brain. These abnormalities can result in other signs of neurological dysfunction, such as mental retardation.
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12.
Main seizure type in ~10% of all people with epilepsy. Usually begins
without warning but same patients experience a predome. The initial
phase of the seizure is usually tonic contraction of muscles throughtout
the body.
Explanation The correct answer is "Generalized, Tonic-Clonic, Grand Mal." This is because the question is asking for the main seizure type in approximately 10% of all people with epilepsy. The answer provided, Generalized Tonic-Clonic (also known as Grand Mal) seizures, fits this description. These seizures typically begin without warning but some patients may experience a prodrome. The initial phase of the seizure is characterized by tonic contraction of muscles throughout the body.
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13.
This type of seizure lasts a couple of seconds, can potentially occur
hundreds of times a day, and is commonly mistaken as "daydreaming" in
children and young adolescents. Poor grades are a common clue to the
existence of this type of seizure.
Explanation Absence seizures, also known as Petit Mal seizures, are a type of seizure characterized by a brief loss of consciousness or awareness. They typically last for a few seconds and can occur multiple times a day. In children and young adolescents, absence seizures are often mistaken as "daydreaming" due to their short duration and subtle symptoms. However, poor grades can be a clue to the presence of absence seizures, as the loss of consciousness during these seizures can disrupt learning and concentration.
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14.
Name the drugs of abuse that can cause seizures.
Explanation Amphetamines, cocaine, phencyclidine, and methylphenidate are all drugs of abuse that have the potential to cause seizures. These drugs can disrupt the normal electrical activity in the brain, leading to abnormal and excessive firing of neurons, which can result in seizures. Seizures can occur as a result of the stimulant effects of these drugs, as well as their impact on neurotransmitters and brain chemistry. It is important to be aware of the potential seizure risk associated with these substances, as seizures can have serious consequences and may require medical intervention.
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15.
This type of seizure is characterized by a brief and sudden muscle
contraction that may involve one part of the body or the entire body. It
is also common for sudden jerking movements to be observed while
falling asleep.
Explanation Myoclonic seizures are characterized by brief and sudden muscle contractions that can affect one part of the body or the entire body. These seizures can occur at any time, including while falling asleep, and are often accompanied by sudden jerking movements.
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16.
This is a type of generalized seizure that is characterized by a sudden loss of postural muscle tone lasting one to two seconds?
Explanation An atonic seizure is a type of generalized seizure where there is a sudden loss of muscle tone, causing a person to lose control of their posture and fall. This seizure typically lasts for one to two seconds.
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17.
What is the most common form of the generalized seizures?
Explanation Tonic-Clonic and Grand Mal are both terms used to describe the most common form of generalized seizures. These seizures are characterized by a loss of consciousness, stiffening of the body (tonic phase), followed by rhythmic jerking movements (clonic phase). The terms Tonic-Clonic and Grand Mal are often used interchangeably to refer to this specific type of seizure.
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18.
What is another name for a generalized, tonic-clonic seizure?
Explanation Grand Mal is another name for a generalized, tonic-clonic seizure. This type of seizure involves a loss of consciousness, stiffening of the body (tonic phase), followed by jerking and convulsions (clonic phase). It is characterized by a sudden and intense electrical disturbance in the brain, affecting both sides of the brain. The term "Grand Mal" is derived from the French language and translates to "great illness."
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19.
This type of epilepsy includes persistent, generalized electrographic
seizures, coma, and tonic-clonic movements. It is an emergency and must
be treated immediately, since cardiorespiratory dysfunction,
hyperthermia, and metabolic derangements can develop as a consequence of
prolonged seizures, and these can lead to irreversible neuronal injury.
Explanation Generalized convulsive status epilepticus (GCSE) is a type of epilepsy characterized by persistent, generalized electrographic seizures, coma, and tonic-clonic movements. It is considered an emergency and requires immediate treatment due to the potential development of cardiorespiratory dysfunction, hyperthermia, and metabolic derangements. Prolonged seizures can lead to irreversible neuronal injury, making it crucial to address GCSE promptly.
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20.
What are the signs and etiology of myoclonic seizures?
Explanation Myoclonic seizures are characterized by a sudden and brief muscle contraction that may involve one part of the body or the entire body. It is most commonly associated with metabolic disorders, degenerative CNS diseases, or anoxic brain injury. It is caused by cortical dysfunction.
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21.
This is the most common type of syndrome associated with complex
partial seizures. It is an example of a symptomatic, partial epilepsy
with distinctive clinical, EEG, and pathologic features. It tends to be
refractory with anticonvulsants, but responds well the surgical
intervention.
Explanation The most common type of syndrome associated with complex partial seizures is Mesial Temporal Lobe Epilepsy Syndrome (MTLE Syndrome). It is considered a symptomatic, partial epilepsy with distinctive clinical, EEG, and pathologic features. This syndrome is often resistant to anticonvulsant medications but tends to respond well to surgical intervention.
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22.
This type of seizure occurs in a discrete region of the brain and
often causes patients to be unable to respond appropriately to visual or
verbal commands and experience impaired recollection or awareness.
Explanation Complex Partial Seizure is the correct answer because it fits the description given in the question. This type of seizure occurs in a specific region of the brain and leads to the inability to respond properly to visual or verbal commands. It also causes impaired recollection or awareness, which aligns with the symptoms mentioned in the question.
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23.
Which type of Seizures are characterized by sudden, brief lapses of
consciousness without loss of postural control? These maybe so brief
they are mistaken for daydreaming.
Explanation Absence seizures, also known as petit mal seizures, are characterized by sudden, brief lapses of consciousness without loss of postural control. These seizures are so brief that they can be mistaken for daydreaming.
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24.
There are many ways to perturb the balance of excitation and
inhibition within the CNS that result in either seizures or epilepsy.
Clinical observations emphasize that the many causes result from a
dynamic interplay between three factors. List these factors.
Explanation The correct answer is endogenous factors, epileptogenic factors, and precipitation factors. These three factors play a dynamic interplay in perturbing the balance of excitation and inhibition within the CNS, leading to seizures or epilepsy. Endogenous factors refer to internal factors within the body that can contribute to the development of seizures. Epileptogenic factors are external factors that can trigger or initiate seizures. Precipitation factors are additional external factors that can exacerbate or worsen seizures once they have been initiated.
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25.
In simple partial seizures, what are the ways that the motor function is affected?
Explanation In simple partial seizures, the motor function can be affected in different ways. One of the ways is through the Jacksonian march, which refers to the progression of muscle jerking or twitching from one part of the body to another. Another way is through Todd's paralysis, which is a temporary weakness or paralysis that occurs after a seizure. Lastly, epilepsia partialis continua is a condition characterized by continuous, repetitive muscle jerking or twitching in a specific part of the body.
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26.
Is a generalized disorder of unknown cause that appears in early
adolescence and is usually characterized by bilateral myoclonic jerks
that may be single or repetitive.
Explanation Juvenile Myoclonic Epilepsy (JME) is a generalized disorder that typically starts in early adolescence and is characterized by bilateral myoclonic jerks. These jerks can be single or repetitive in nature. The exact cause of JME is unknown. The answer provided includes the full name "Juvenile Myoclonic Epilepsy" as well as the abbreviation "JME" which are both correct ways to refer to this disorder.
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27.
Recent epilepsy research has led to findings of gene mutations
associated with several of the epilepsy syndromes. It appears that in
the relatively "pure" forms of epilepsy, mutaions affecting ______ are
the cause, while gene mutaions observed in symptomatic epilepsies are
associated with ____?
Explanation Answer 1: ion channel function
Answer 2: pathways influencing CNS development or neuronal homeostatsis
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28.
This injury is associated with up to a 50% risk of subsequent epilepsy and/or other seizure disorder.
Explanation Penetrating head trauma refers to an injury where an object penetrates the skull and enters the brain. This type of injury can cause significant damage to the brain tissue and disrupt normal brain function. Due to the severity of the injury, individuals who experience penetrating head trauma have an increased risk of developing epilepsy and/or other seizure disorders. This is because the trauma can lead to changes in the brain's electrical activity, making it more susceptible to seizures.
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29.
The process by which a normal brain develops epilepsy (a chronic condition in which seizures occur).
Explanation Epileptogenesis refers to the process through which a normal brain develops epilepsy, a chronic condition characterized by recurring seizures. It involves various mechanisms that lead to the initiation and progression of epilepsy, including changes in neuronal excitability, abnormal synaptic connections, and alterations in brain circuitry. Epileptogenesis can be triggered by various factors such as genetic predisposition, brain injury, infections, or other neurological disorders. Understanding the process of epileptogenesis is crucial for developing effective treatments and interventions to prevent or manage epilepsy.
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30.
This syndrome occurs in children and is defined by a a triad
consisting of (1) multiple seizures types; (2) an EEG showing slow
(<3 Hz) spike-and-wave discharges and a variety of other
abnormalities; and (3) impaired cognitive function in most but not all
cases.
Explanation Lennox-Gastaut Syndrome is a syndrome that occurs in children and is characterized by three main features. Firstly, it involves multiple seizure types, meaning that children with this syndrome experience different types of seizures. Secondly, an electroencephalogram (EEG) of these children shows slow spike-and-wave discharges at a frequency of less than 3 Hz, as well as other abnormal findings. Lastly, most children with Lennox-Gastaut Syndrome have impaired cognitive function, although not all cases exhibit this feature. Overall, these three defining characteristics help diagnose and identify Lennox-Gastaut Syndrome in children.
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31.
All patients who have a possible sizure disorder should be evaluated with an___ as soon as possible
Explanation All patients who have a possible seizure disorder should be evaluated with an EEG as soon as possible because an EEG, or electroencephalogram, is a diagnostic test that measures the electrical activity of the brain. It can help detect abnormal brain waves that may indicate a seizure disorder. By performing an EEG, healthcare professionals can gather valuable information about the patient's brain activity and make an accurate diagnosis. Early evaluation with an EEG is crucial in order to initiate appropriate treatment and management for patients with a possible seizure disorder.
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32.
Seizures in older adults are usually caused by what? (4 answers)
Explanation Seizures in older adults are typically caused by a variety of factors. Cerebrovascular disease refers to conditions that affect the blood vessels in the brain, such as stroke or transient ischemic attack, which can disrupt normal brain function and lead to seizures. Trauma, such as head injuries, can also trigger seizures in older adults. CNS tumors, which are abnormal growths in the brain or spinal cord, can cause seizures as well. Additionally, degenerative diseases like Alzheimer's or Parkinson's can contribute to the development of seizures in older adults.
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33.
Name the metabolic disturbances that can lead to seizures at any age.
Explanation Seizures can occur as a result of metabolic disturbances such as electrolyte imbalance, hypo- or hyperglycemia, renal failure, and hepatic failure. Electrolyte imbalance refers to an abnormal concentration of electrolytes in the body, which can disrupt the electrical activity of the brain and lead to seizures. Hypo- or hyperglycemia, which is low or high blood sugar levels respectively, can also cause seizures by affecting the brain's energy supply. Renal failure and hepatic failure can lead to the accumulation of toxins in the body, which can trigger seizures.
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34.
Little is known about the specific factors that determine precisely
when a seizure will occur in a patient with epilepsy. However there are
possible situations that have shown a decrease in a patient's seizure
threshold. What are some of these possible situations?
Explanation Sleep deprivation, increased alcohol intake, highly specific stimuli from video games, music or an individual's voice, and stress are all possible situations that have shown a decrease in a patient's seizure threshold. These factors can trigger seizures in patients with epilepsy, although the specific mechanisms behind this are not fully understood. It is important for individuals with epilepsy to be aware of these potential triggers and take steps to manage them in order to reduce the risk of seizures.
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35.
These seizures are nonepileptic behaviors that resemble seizures.
They are often part of a conversion reaction precipitated by underlying
psychological distress. Certain behaviors such as side-to-side turning
of the head, twitching of all 4 extrimities without loss of
consciousness, and pelvic thrusts are usually associated with these
types of seizures. What are they?
Explanation Psychogenic seizures are nonepileptic behaviors that mimic seizures. They are typically seen in individuals experiencing psychological distress and are part of a conversion reaction. The specific behaviors mentioned, such as head turning, twitching of all four extremities, and pelvic thrusts, are commonly associated with psychogenic seizures.
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36.
Certain conditions can cause chronic seizure disorder. An example of
this is severe head trauma, as it greatly increases the risk of
subsequent epilepsy. What is the name for the process that transforms a
normal neural network into one that is abnormally hyperexcitable?
Explanation Epileptogenesis is the process by which a normal neural network transforms into one that is abnormally hyperexcitable. This can occur as a result of certain conditions such as severe head trauma, which greatly increases the risk of developing epilepsy.
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37.
This phase is characterized by the eyes rolling back in the head.
Also in this phase the initial tremors progress to violent muscular
jerking movements and frothing and drooling from the mouth is observed.
Explanation The correct answer is the clonic phase. This phase is characterized by the eyes rolling back in the head and the initial tremors progressing to violent muscular jerking movements. Additionally, frothing and drooling from the mouth are observed during this phase.
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38.
This
type is the most common syndrome associated with complex partial
seizures and is an example of symptomatic, partial epilepsy with
distinctive clinical, electroencephalographic, and pathologic features.
Recognition of this syndrome is especially important because it tends to
be refractory to treatment with anticonvulsants but responds extremely
well to surgical intervention.
Explanation Mesial Temporal Lobe Epilepsy (MTLE) is the most common syndrome associated with complex partial seizures. It is characterized by distinctive clinical, electroencephalographic, and pathologic features. MTLE is considered symptomatic and refractory to treatment with anticonvulsants, meaning it does not respond well to medication. However, it has been found to respond extremely well to surgical intervention. Therefore, recognizing MTLE is crucial for determining the appropriate treatment approach for patients with this type of epilepsy.
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39.
This term describes a condition in which a person has recurrent seizures due to a cronic, underlying process.
Explanation Epilepsy is a neurological disorder characterized by recurrent seizures. These seizures are caused by a chronic and underlying process in the brain. The term "epilepsy" is used to describe this condition because it encompasses the ongoing and repetitive nature of the seizures. It is important to note that epilepsy can have various causes and can affect individuals of all ages.
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40.
What type of generalized seizure is characterized by a sudden loss of postural muscle tone lasting one to two seconds?
Explanation Atonic seizures are a type of generalized seizure that is characterized by a sudden loss of postural muscle tone lasting one to two seconds. During these seizures, the muscles become limp, causing the person to fall or drop their head or limbs. This loss of muscle tone can result in injuries from falls. Atonic seizures are also known as drop attacks and can occur in individuals with epilepsy.
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41.
Characteristics of atonic seizures
Explanation Loss of postural muscle tone for 1-2s
Consciousness is briefly impaired
No postictal confusion
usually seen with known epileptic syndromes
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42.
A form of idiopathic lateral temporal lobe epilepsy with auditory
symptoms or aphasia as a major simple partial seizure manifestation; age
of onset usually between 10 and 25 years of age.
Explanation This is a form of epilepsy characterized by seizures that originate in the temporal lobe of the brain and are accompanied by auditory symptoms or aphasia. It is inherited in an autosomal dominant manner, meaning that a person only needs to inherit one copy of the mutated gene from one parent to develop the condition. The age of onset for this type of epilepsy is typically between 10 and 25 years of age. It is commonly referred to as ADPEAF, which stands for Autosomal Dominant Partial Epilepsy with Auditory Features.
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43.
A young man that I used to coach would have "episodes" on the
practice field where he would become unattached. He would stare off
into the distance and would not respond to verbal or physical contact.
When he "came back" he would be very confused and would take some time
to become coherent enough to rejoin practice. The first time it
happened this seemed to last for a few minutes but the last episode I
witnessed lasted for over 20 minutes. This young man started having
grand mal seizures a few years later and was diagnosed with epilepsy
which he has taken control of with medication. What type of seizures
was this young man having?
Explanation The young man in the scenario is experiencing complex partial seizures. This is evident from the description of his "episodes" on the practice field, where he becomes unattached, stares off into the distance, and does not respond to verbal or physical contact. These are common symptoms of complex partial seizures, where the person loses awareness and may exhibit repetitive movements or behaviors. The fact that the episodes lasted for a few minutes initially but became longer over time is also consistent with complex partial seizures. The later diagnosis of epilepsy further supports this conclusion.
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44.
This type of epilepsy (aka Lafora's Disease) is autosomal recessive
inheritance, it's onset is age 6-19, death within 10 years; brain
degeneration associated with polyglucosan intracellular inclusion bodies
in numerous organs.
Explanation Progressive myoclonus epilepsy is a type of epilepsy that is characterized by the progressive development of myoclonus (involuntary muscle jerks or twitches) and seizures. It is autosomal recessive, meaning that both parents must carry the gene for the disorder in order for their child to be affected. The onset of symptoms typically occurs between the ages of 6 and 19, and if left untreated, it can lead to death within 10 years. The disease is associated with brain degeneration and the formation of polyglucosan intracellular inclusion bodies in various organs.
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45.
This clinical feature of a tonic-clonic (grand mal) seizure involves continuous seizure activity with great risk for brain hypoxia, and is a life threatening medical emergency.
Explanation Status epilepticus is a medical condition characterized by continuous seizure activity, which poses a significant risk for brain hypoxia. This means that during a tonic-clonic seizure, the person experiences prolonged and uninterrupted seizure activity, leading to a lack of oxygen supply to the brain. This is considered a life-threatening medical emergency because it can result in severe brain damage or even death if not promptly treated. Therefore, status epilepticus is the correct answer as it accurately describes the clinical feature mentioned in the question.
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46.
A generalized seizure disorder of unknown cause that appears in early
adolescence and is characterized by bilateral myoclonic jerks (either
single or repetitive). The myoclonic seizures are most frequent in the
morning and can be provoked by sleep deprivation.
Explanation Juvenile Myoclonic Epilepsy is a type of seizure disorder that typically begins in early adolescence. It is characterized by bilateral myoclonic jerks, which can be single or repetitive. These myoclonic seizures are most common in the morning and can be triggered by sleep deprivation. The cause of this disorder is unknown.
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47.
This type of epilepsy syndrome is characterized by uncontrolled
seizures and mental retardation. Distinct, identifiable pathologies like
a history of perinatal asphyxiation or congenital brain malformations
are also common with this syndrome.
Explanation Lennox-Gastaut syndrome (LGS) is a type of epilepsy syndrome that is characterized by uncontrolled seizures and mental retardation. It is often associated with distinct, identifiable pathologies such as a history of perinatal asphyxiation or congenital brain malformations. LGS is a complex and severe form of epilepsy that typically starts in childhood and can have a significant impact on cognitive and developmental abilities.
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48.
In petit mal (or _____________) seizures, the patient often exhibits the following symptoms:
Staring into space, without unusual movement
Lip smacking
Fluttering eyelids
Repetitive chewing movements
Hand movements
Small movements of both arms
This type of seizure may seem
mild in comparison to other seizure types such as tonic-clonic, but
sufferers are discouraged from driving and from swimming without
supervision.
Explanation Petit mal seizures, also known as absence seizures, are characterized by brief episodes of staring into space without any unusual movement. Other symptoms include lip smacking, fluttering eyelids, repetitive chewing movements, hand movements, and small movements of both arms. Although these seizures may seem mild compared to other seizure types, individuals with absence seizures are discouraged from driving and swimming without supervision due to the risk of sudden loss of awareness and control.
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