Nervous system

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Questions and Answers

What is a characteristic of absence seizures?

  • They are brief and mild episodes. (correct)
  • They can last for 1 to 2 minutes.
  • They typically result in loss of consciousness.
  • They involve major muscle contractions.

Which neurotransmitter is primarily excitatory and encourages neuron firing?

  • Glutamate (correct)
  • Dopamine
  • GABA
  • Serotonin

What type of imaging technique can be used for the diagnosis of epilepsy?

  • Electrocardiography
  • X-ray
  • Ultrasound
  • MRI (correct)

What might occur if seizures in epilepsy cannot be controlled?

<p>The individual may need to avoid harmful activities. (B)</p> Signup and view all the answers

How do sodium and potassium ions relate to action potentials in neurons?

<p>Sodium ions create action potentials, potassium ions inhibit them. (A)</p> Signup and view all the answers

What primarily characterizes epilepsy?

<p>A chronic series of recurrent seizures (D)</p> Signup and view all the answers

Which of the following is NOT a symptom associated with seizures?

<p>Chronic headaches (A)</p> Signup and view all the answers

How are seizures and epilepsy differentiated?

<p>Seizures can occur singularly, while epilepsy involves ongoing seizure activity (A)</p> Signup and view all the answers

What do convulsions refer to in the context of seizures?

<p>Sudden involuntary muscular contractions and relaxations (B)</p> Signup and view all the answers

Which condition is most likely to result in seizures as a secondary symptom?

<p>Alzheimer's Disease (A)</p> Signup and view all the answers

What is a primary characteristic of non-convulsive seizures?

<p>They may not involve noticeable physical manifestations (D)</p> Signup and view all the answers

In which condition can seizures occur frequently without a known cause?

<p>Epilepsy (D)</p> Signup and view all the answers

Which of the following statements about seizures is incorrect?

<p>Seizures are always convulsive in nature. (A)</p> Signup and view all the answers

What is a common sign of a seizure that involves loss of consciousness?

<p>Extended blank stare (D)</p> Signup and view all the answers

Which type of seizure is characterized by a single locus of hyperactive neurons and does not involve a loss of consciousness?

<p>Simple partial seizure (D)</p> Signup and view all the answers

Which symptom is NOT typically associated with seizures?

<p>Increased heart rate (B)</p> Signup and view all the answers

What distinguishes complex partial seizures from simple partial seizures?

<p>Altered consciousness and sensory hallucinations (C)</p> Signup and view all the answers

What can happen if a simple partial seizure progresses?

<p>It can become a generalized tonic–clonic seizure. (C)</p> Signup and view all the answers

Which sign is often associated with generalized body movements during seizures?

<p>Jerking body movements (D)</p> Signup and view all the answers

Which aspect is not characteristic of focal seizures?

<p>Can cause loss of consciousness (C)</p> Signup and view all the answers

What is a potential visual cue of seizure activity in a person?

<p>Eyes rolling upward (B)</p> Signup and view all the answers

What is the mechanism by which certain antiseizure drugs delay neuronal action potentials?

<p>Delaying an influx of sodium (C)</p> Signup and view all the answers

Which of the following antiseizure drugs primarily acts by increasing the availability of GABA in the brain?

<p>Vigabatrin (A)</p> Signup and view all the answers

Which class of antiseizure medications enhances the action of GABA at the GABAA receptor?

<p>Benzodiazepines (D)</p> Signup and view all the answers

How do drugs like carbamazepine and valproate reduce high-frequency neuronal activity?

<p>By inhibiting sodium channels (A)</p> Signup and view all the answers

Which mechanism is involved in the action of GABA in the brain?

<p>Stimulating an influx of chloride ions (D)</p> Signup and view all the answers

What is the primary effect of chloride ions entering the neuron when the receptor is stimulated?

<p>It suppresses the ability of neurons to fire. (C)</p> Signup and view all the answers

What is the role of phenobarbital in relation to GABA?

<p>It enhances the action of released GABA (C)</p> Signup and view all the answers

What is the effect of increasing chloride ion influx on neuronal activity?

<p>It suppresses neuronal activity (A)</p> Signup and view all the answers

Which type of calcium channels is primarily involved in the generation of absence seizures?

<p>T-type calcium channels (C)</p> Signup and view all the answers

Which anticonvulsant primarily works by inhibiting GABA reuptake?

<p>Tiagabine (A)</p> Signup and view all the answers

What is the mechanism by which ethosuximide, valproate, and lamotrigine help control absence seizures?

<p>They reduce calcium current. (B)</p> Signup and view all the answers

How do antiseizure drugs affect calcium entry into neurons?

<p>They block calcium channels to delay calcium entry. (B)</p> Signup and view all the answers

What effect does an increased electrical threshold have on the likelihood of seizures?

<p>It increases the electrical threshold, reducing the likelihood of seizures. (B)</p> Signup and view all the answers

What characterizes atonic seizures?

<p>Loss of muscle tone leading to drop attacks (B)</p> Signup and view all the answers

Which type of seizure is characterized by both tonic and clonic phases?

<p>Tonic-clonic (grand mal) (B)</p> Signup and view all the answers

Which drug class is phenytoin a part of?

<p>Hydantoins (D)</p> Signup and view all the answers

What defines status epilepticus?

<p>A seizure lasting longer than 30 minutes (A), Continuous seizure activity with no recovery (D)</p> Signup and view all the answers

Which of the following options describes absence seizures?

<p>Brief blanking out or daydreaming effect (C)</p> Signup and view all the answers

Which antiseizure drug is the newest in the hydantoins class?

<p>Fosphenytoin (B)</p> Signup and view all the answers

What are typical symptoms of myoclonic seizures?

<p>Brief shock-like jerks of muscles (A)</p> Signup and view all the answers

Which group of antiseizure drugs includes drugs that are useful for absence seizures?

<p>Succinimides (C), Phenytoin-like agents (D)</p> Signup and view all the answers

Flashcards

Seizure

A brief, temporary disturbance in the brain's electrical activity, affecting muscle control, speech, vision, awareness, and behavior.

Epilepsy

A chronic neurological disorder causing frequent seizures, often without a known cause.

Seizure vs. Epilepsy

Seizures are a symptom of an underlying health problem (often temporary); epilepsy is a chronic condition of recurring seizures.

Convulsion

An involuntary, sudden attack of muscular contractions and relaxations during a seizure.

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Dementia

A group disorders involving loss of memory and other cognitive functions.

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Alzheimer's Disease

A specific type of dementia characterized by progressive memory loss and cognitive decline.

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Parkinsonism

A neurological disorder causing movement problems, such as tremors and rigidity.

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Nociception

The sensory process that detects and signals potentially damaging stimuli.

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Pyrexia

Fever; an increase in body temperature.

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Depression

A mood disorder characterized by persistent sadness, loss of interest, and other symptoms.

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Focal Seizure

A seizure that involves only a portion of the brain, often a specific lobe in one hemisphere.

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Simple Partial Seizure

A focal seizure where the abnormal electrical activity stays in one place and doesn't spread; awareness is maintained.

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Complex Partial Seizure

A focal seizure with altered awareness and sensory/mental distortions; motor dysfunction, like chewing or urination, may occur.

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Generalized Seizure

A seizure affecting the whole brain.

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Signs of a Seizure

Observable symptoms like blank stares, jerking movements, loss of consciousness, and difficulty with attention.

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Partial (Focal) Seizure

Excessive electrical activity in one brain hemisphere affecting only that part of the body.

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Epilepsy Seizures

Epilepsy seizures are episodes of abnormal electrical activity in the brain, ranging from brief absence seizures to major convulsions.

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Absence Seizures

A type of epilepsy seizure characterized by brief, mild episodes.

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Grand Mal Seizures

A type of major epilepsy seizure involving loss of consciousness, convulsions, and sensory disturbances.

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Psychomotor Seizures

Epilepsy seizures marked by disorientation lasting approximately one to two minutes.

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Epilepsy Causes

Epilepsy can be caused by tumors, injuries, or other neurological diseases, but often the cause is unknown.

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EEG

Electroencephalography study used to record brain electrical activity, helpful in diagnosing epilepsy.

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Neurotransmitters

Small molecules that transmit signals between neurons.

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Glutamate

Excitatory neurotransmitter (triggers neurons to fire).

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GABA

Inhibitory neurotransmitter (slows neuron firing).

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Sodium Ions (Na+)

Essential in creating action potentials (electrical signals).

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Potassium Ions (K+)

Essential in controlling the action potential.

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Action Potential

An electrical signal traveling down a neuron's axon.

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Generalized Seizures

Seizures that involve excessive electrical activity in both cerebral hemispheres, usually originating in the thalamus or brainstem, affecting the whole body, and commonly causing loss of consciousness.

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Atonic Seizures

Seizures characterized by a sudden loss of muscle tone, often referred to as drop attacks.

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Myoclonic Seizures

Seizures involving brief, shock-like muscle jerks, which can be generalized or limited to a body part.

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Tonic Seizures

Seizures marked by a sudden stiffening of the body, arms, or legs.

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Clonic Seizures

Seizures characterized by rhythmic jerking movements of the arms and legs, without a tonic component.

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Tonic-clonic (grand mal) Seizures

Seizures that progress through a tonic phase followed by a clonic phase.

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Absence (petit mal) Seizures

Seizures characterized by a person appearing to "blank out" or "daydream".

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Status Epilepticus

A seizure lasting longer than 30 minutes or a series of three or more seizures without a normal period in between, potentially fatal and often requiring emergency intervention.

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Antiseizure Drugs

Drugs used to suppress or prevent abnormal or repetitive firing of brain neurons.

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Phenytoin

A common antiseizure drug from the hydantoin class.

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Fosphenytoin

A newer antiseizure drug belonging to the hydantoin class, noted for treating status epilepticus.

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Chloride ion movement

Chloride ions enter neurons, reducing firing ability.

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Barbiturates and benzodiazepines

Drugs that reduce seizures by decreasing neuron firing.

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Calcium channels and seizures

Anticonvulsant drugs block calcium channels decreasing seizure activity.

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Absence seizures

Oscillations between thalamus and cortex; involve T-type calcium channels.

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Ethosuximide, valproate, lamotrigine

Drugs reducing calcium current, dampening absence seizures.

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Calcium influx delay

Antiseizure drugs slow calcium entry into neurons to prevent abnormal firing.

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Electrical threshold increase

Blocking calcium channels raises the electrical threshold, reducing abnormal firing.

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Antiseizure Drug Mechanisms

Antiseizure drugs work through three main mechanisms: stimulating chloride ion influx, delaying sodium influx, and delaying calcium influx.

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Sodium Channel Blockade

Some antiseizure drugs, like Carbamazepine and Phenytoin, block sodium channels, preventing excessive neuronal activity.

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Inactivated Sodium Channels

Antiseizure drugs often bind preferentially to inactivated sodium channels, keeping them in that state and reducing the sodium current.

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GABA Action Enhancement

Other antiseizure drugs, such as benzodiazepines, increase the effects of GABA, which is an inhibitory neurotransmitter.

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GABA-Transaminase Inhibition

Vigabatrin inhibits GABA-transaminase, which leads to increased GABA levels and enhanced central inhibition.

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GABA Reuptake Inhibition

Tiagabine inhibits GABA reuptake, leading to more GABA in the synaptic cleft for enhanced inhibition.

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Chloride Ion Influx Stimulation

Certain antiseizure drugs mimic GABA's effects by stimulating chloride ion influx, which further inhibits neuronal activity.

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Gamma-aminobutyric acid (GABA)

Inhibitory neurotransmitter in the brain which promotes chloride ion influx.

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Study Notes

Unit 1: Nervous System

  • Covers the definition, pathophysiology, causes, signs, symptoms, management, and complications of various nervous system disorders.
  • Included disorders are seizures, parkinsonism, dementia (Alzheimer's Disease), depression, nociception (central and peripheral), and pyrexia.

Nervous System Anatomy

  • The nervous system, including the brain, spinal cord, and peripheral nerves, is depicted.
  • A diagram of a motor neuron illustrates dendrites, cell body, nucleus, axon, myelin sheath, and neuromuscular junction, with labeled parts.
  • Brain regions depicted include frontal, parietal, temporal, and occipital lobes.

What is a Seizure?

  • A seizure is a brief, temporary disruption of brain electrical activity affecting muscle control, speech, vision, and awareness.
  • Seizures can be convulsive or non-convulsive, and vary in frequency and severity.

Seizures vs. Epilepsy

  • Seizures may be symptoms of an underlying medical condition (e.g., fever, illness).
  • Epilepsy is a chronic disorder characterized by recurrent seizures.

Epilepsy

  • A neurological disorder making people susceptible to seizures.
  • Seizures are chronic (ongoing and frequent).
  • Seizures might occur without a known cause.
  • Many experience multiple types of seizures.

Causes of Seizures

  • Head injury (e.g., accidents, falls).
  • Intracerebral injuries (e.g., tumors, strokes).
  • Birth injury/complications.
  • Metabolic disorders
  • Fever
  • Congenital disorders
  • Infections (e.g., meningitis)
  • Heredity

Unit 1: Seizures - Causes (Triggers)

  • Missed medication dose
  • Sleep deprivation
  • Illness
  • Stress/anxiety/overstimulation
  • Hormonal changes
  • Alcohol and drug use
  • Hyperventilation
  • Flashing lights
  • Temperature extremes/dehydration

Types of Seizures

  • Focal (partial): Occurs in part of the brain. Includes simple and complex partial seizures.
  • Generalized: Affects the entire brain. Includes tonic, atonic, tonic-clonic, myoclonic, and absence seizures.

Pathophysiology

  • Epilepsy is characterized by recurrent seizures from abnormal brain electrical activity.
  • Seizures can range from mild absences or major convulsive events.
  • Psychomotor seizures involve a period of disorientation lasting 1-2 minutes.

Diagnosis

  • Electroencephalography (EEG) studies detect brain activity abnormalities.
  • Antiepileptic and anticonvulsant drugs, and sometimes surgery, control seizures.
  • Careful monitoring, medical history & physical exam, and imaging are crucial.

Nerve Cell Communication

  • Neurons communicate using neurotransmitters which regulate electrical activity.
  • Glutamate is excitatory (triggers firing), while GABA is inhibitory (reduces firing).
  • Sodium (Na+) and potassium (K+) ions create action potentials in neurons.

Stages of a Seizure

  • Aura (initial warning symptoms), tonic (muscle stiffness), clonic (muscle jerking), and postictal (recovery phase).

Signs of a Seizure

  • Extended blank stare, unusual eye movements, rapid blinking, rolling eyes upward, unresponsiveness.
  • Inability to pay attention, repetitive movements, body parts jerking, loss of consciousness, loss of body control, etc.

Types of Seizures - Diagram

  • Illustrations distinguish generalized and partial seizures for visual understanding of their differing effects.

Types of Seizures - Detailed

  • Focal seizures, including simple and complex partial seizures.
  • Generalized seizures, including tonic-clonic, absence, myoclonic, clonic, and atonic seizures.

Generalized Seizures

  • Excessive electrical activity in both cerebral hemispheres.
  • Typically originates in brainstem or thalamus; affects the whole body.

Antiseizure Drugs

  • Classifications such as barbiturates, benzodiazepines, hydantoins, phenytoin-like agents, and succinimides.
  • Drugs work by suppressing abnormal neuron firing.
  • Some drugs work by influencing sodium and chloride ion influx while others enhance GABA (inhibitory signal).

Adverse Effects of Antiseizure Medications

  • A variety of potential adverse effects, such as nausea, dizziness, hyponatremia, weight gain/loss, atxia, and rash. Noteable effects included in a table format(Drug, Mechanism, Adverse Effects).

Case Studies

  • Illustrate real-life examples of seizure presentation, including typical characteristics. Example includes a 10-year-old experiencing a seizure.

Benign Rolandic Epilepsy

  • Genetic, focal epilepsy with onset in childhood.
  • Characterized by centrotemporal spikes (in EEG) that typically resolve.
  • Hemifacial parasthesias.
  • Motor seizures, speech arrest, or drooling, mostly during sleep or awakening.

References

  • Various texts and resources are cited.

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