Neurophysiology and Pathophysiology Quiz
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Questions and Answers

What type of seizures can commonly affect the frontal lobe and other parts of the brain?

  • Partial seizures
  • Focal seizures (correct)
  • Complex seizures
  • Generalized seizures
  • What is the common characteristic of focal seizures that affect the parietal lobe?

  • Memory impairment
  • Uncontrollable muscle contractions
  • Sensory disturbances (correct)
  • Loss of consciousness
  • Which part of the brain is commonly involved in generalized seizures?

  • Cerebellum
  • Frontal lobe
  • Parietal lobe
  • Thalamus (correct)
  • What is the typical duration of a generalized tonic-clonic seizure?

    <p>2-5 minutes (D)</p> Signup and view all the answers

    What is a defining characteristic of the tonic phase of a generalized tonic-clonic seizure?

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

    What usually follows a generalized seizure?

    <p>A period of confusion and fatigue (A)</p> Signup and view all the answers

    What can happen to focal seizures?

    <p>They can spread and become generalized seizures (B)</p> Signup and view all the answers

    What is the term for the state immediately following a seizure?

    <p>Post-ictal state (D)</p> Signup and view all the answers

    What is the primary risk associated with status epilepticus?

    <p>Permanent neurologic damage (B)</p> Signup and view all the answers

    Which of the following medications is used for the immediate management of status epilepticus?

    <p>Lorazepam (C)</p> Signup and view all the answers

    What denotes status epilepticus?

    <p>Continuous seizure activity for over 5 minutes (D)</p> Signup and view all the answers

    What can result from untreated status epilepticus?

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

    Which of the following is considered a long-acting anticonvulsant for treating seizures?

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

    What is a primary reason that hemorrhagic strokes have a higher seizure potential compared to ischemic strokes?

    <p>Direct leakage of pro-inflammatory cytokines onto neurons (B)</p> Signup and view all the answers

    Which type of stroke is primarily associated with thrombi or thromboembolic disease?

    <p>Ischemic Stroke (C)</p> Signup and view all the answers

    Which condition is least likely to contribute to metabolic causes of seizures?

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

    What type of infectious illness is associated with seizures?

    <p>Lyme Disease (C)</p> Signup and view all the answers

    Which of the following is primarily categorized as a neoplastic cause of seizures?

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

    What occurs during depolarization of a neuron?

    <p>Sodium ions flow into the neuron. (C)</p> Signup and view all the answers

    What is the typical resting membrane potential of neurons in the CNS and PNS?

    <p>-70 mV (C)</p> Signup and view all the answers

    Which ion's movement is primarily responsible for the repolarization phase of the action potential?

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

    What component is directly involved in neurotransmitter release following an action potential?

    <p>Voltage-gated calcium channels (B)</p> Signup and view all the answers

    How does the expression of receptors in the post-synaptic neuron affect neurotransmitter binding?

    <p>It allows for neurotransmitter binding to occur. (C)</p> Signup and view all the answers

    What is the role of regulatory/modulatory enzymes in neurotransmitter function?

    <p>To biochemically inactivate neurotransmitters. (A)</p> Signup and view all the answers

    What initiates the action potential in response to stimulation?

    <p>Sodium ions entering the neuron. (C)</p> Signup and view all the answers

    Which process leads to the transmission of electrochemical current down the axon?

    <p>Influx of sodium and efflux of potassium. (A)</p> Signup and view all the answers

    Which infectious agent is most commonly associated with meningitis in HIV/AIDS patients?

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

    What is the primary cause of chronic trauma-induced seizures?

    <p>Abnormal neuronal remodeling (B)</p> Signup and view all the answers

    Which autoimmune disease is most commonly associated with seizures?

    <p>Systemic Lupus Erythematosus (A)</p> Signup and view all the answers

    Which of the following is a potential consequence of increased NMDA and AMPA receptor activity?

    <p>Enhanced neuronal damage (A)</p> Signup and view all the answers

    Which condition is primarily associated with bitemporal encephalitis?

    <p>Herpes Simplex Virus infections (A)</p> Signup and view all the answers

    What is the effect of trauma-induced seizures on glutamate levels?

    <p>Glutamate levels increase (D)</p> Signup and view all the answers

    Which disease is linked to post-viral syndromes following infections such as RSV or influenza?

    <p>Systemic Lupus Erythematosus (D)</p> Signup and view all the answers

    Which of the following is NOT a mosquito-borne infectious cause of seizures?

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

    What is the primary consequence of chronic alcohol use on GABAA receptors?

    <p>Downregulation of available GABAA receptors (C)</p> Signup and view all the answers

    What symptoms are indicative of alcohol withdrawal syndrome?

    <p>Heart palpitations and tremors (B)</p> Signup and view all the answers

    Which medication is used for the acute management of alcohol withdrawal agitation?

    <p>Lorazepam (C)</p> Signup and view all the answers

    What condition can occur 48-96 hours after the last drink in chronic alcoholics?

    <p>Delirium Tremens (C)</p> Signup and view all the answers

    Which pharmacological approach is employed to help restore GABA sensitivity in alcohol withdrawal?

    <p>Long-acting benzodiazepines (B)</p> Signup and view all the answers

    What is the mechanism of action for Topiramate in seizure management?

    <p>Blockade of AMPA receptors and GABA potentiation (A)</p> Signup and view all the answers

    What is the first-line management for absence seizures?

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

    Which of the following medications acts by blocking voltage-gated sodium channels?

    <p>Valproic Acid (C)</p> Signup and view all the answers

    What effect does alcohol withdrawal have on CNS activity?

    <p>CNS hyper-reactivity (C)</p> Signup and view all the answers

    Which action does Levitiracetam target to achieve its anti-seizure effects?

    <p>SV2A blockade (B)</p> Signup and view all the answers

    Flashcards

    Status Epilepticus

    A medical emergency with continuous seizure activity for over 5 minutes or recurrent seizures without recovery of consciousness.

    Medical Emergency

    A condition that requires immediate medical intervention to prevent serious consequences.

    Benzodiazepine

    A class of medications used to treat anxiety and seizures; examples include Lorazepam and Midazolam.

    Long-acting Anticonvulsants

    Medications like Phenytoin and Valproic Acid used to prevent seizures over extended periods.

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    Phenobarbital

    A barbiturate used to control seizures, particularly in status epilepticus.

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    Ischemic Stroke

    A type of stroke caused by blood clots, leading to reduced blood flow in the brain.

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    Hemorrhagic Stroke

    A type of stroke resulting from bleeding in or around the brain.

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    Seizure Risk in Strokes

    Hemorrhagic strokes have a higher seizure risk compared to ischemic strokes due to inflammatory responses.

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    Pathophysiologic Etiologies

    The underlying causes of seizures that include vascular, infectious, traumatic, autoimmune, and more.

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    Oxidative Stress in Neurons

    An imbalance causing increased neuronal excitability, often triggered by vascular causes.

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    Electrochemical excitability

    The ability of neurons to generate action potentials through ion movement.

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    Nerve action potential

    A change in membrane potential leading to nerve signal transmission.

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    Resting membrane potential

    The voltage of a neuron at rest, typically around -70 mV.

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    Depolarization

    A decrease in membrane potential making the inside of the cell more positive.

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    Repolarization

    The process of restoring the membrane potential after depolarization.

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    Voltage-gated calcium channels

    Channels that open in response to membrane depolarization, allowing calcium influx.

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    Neurotransmitter binding

    The process when neurotransmitters attach to receptors on a post-synaptic neuron.

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    Synaptic transmission

    The process of neurotransmitter release and action across synapses.

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    Meningitis

    An infection causing inflammation of the protective membranes covering the brain and spinal cord.

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    Streptococcus Pneumoniae

    A bacteria often associated with pneumonia and meningitis, particularly in COPD patients.

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    Neisseria Meningitidis

    A bacterial cause of meningitis, commonly affecting young adults in close quarters.

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    Cryptococcal Meningitis

    The most common cause of meningitis in HIV/AIDS patients, caused by a fungus.

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    Encephalitis

    Inflammation of the brain, often infectious, leading to neurological symptoms.

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    Herpesviruses

    A group of viruses, including HSV-1 and HSV-2, known to cause bitemporal encephalitis.

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    Trauma-Induced Seizures

    Seizures that occur as a result of brain injury, can be acute or chronic.

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    Systemic Lupus Erythematosus (SLE)

    An autoimmune disease often associated with increased seizure risk due to neuronal damage.

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    Frontal Lobe Seizures

    Seizures affecting motor functions and may cause clonic jerking.

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    Parietal Lobe Seizures

    Seizures causing sensory deficits like numbness or burning sensations.

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    Generalized Seizures

    Seizures that usually involve both hemispheres without a specific brain focus.

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    Post-Ictal State

    The state of confusion and fatigue following a seizure.

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    Generalized Tonic-Clonic Seizures

    Seizures that start with muscle stiffening followed by jerking movements.

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    Clonic Jerking

    Uncontrollable muscle movements occurring in certain seizures.

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    Neuronal Projections

    Connections that communicate between the thalamus and brain regions.

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    Loss of Consciousness

    A state where the patient is not aware of surroundings, often during seizures.

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    GABAA Receptors

    Receptors that mediate inhibitory neurotransmission in the CNS.

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    Alcohol Withdrawal

    Symptoms occurring after sudden cessation of alcohol, leading to CNS hyper-reactivity.

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    Delirium Tremens

    Severe and life-threatening withdrawal symptoms including seizures and hallucinations.

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    IV Lorazepam

    Medication used for acute agitation in alcohol withdrawal.

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    GABA Potentiation

    Increased effectiveness of GABA at its receptors.

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    SV2A Inhibitor

    Blocks protein that packages neurotransmitters, balancing GABA and glutamate.

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    Topiramate

    Anti-seizure drug with multiple mechanisms including sodium and calcium channel blockade.

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    Valproic Acid

    Medication that increases GABA effect and blocks sodium channels for seizure management.

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    Ethosuximide

    First-line treatment for absence seizures, blocking calcium channels in the thalamus.

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    Calcium Channel Blockade

    Reduces neurotransmitter release, dampening excitability.

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    Study Notes

    Pathophysiology of Seizures

    • Seizures are characterized by abnormal hyperexcitability in the brain, potentially causing loss of consciousness, and or motor or non-motor symptoms
    • The brain's primary excitatory neurotransmitter is glutamate, which promotes neuronal depolarization
    • Inhibitory neurotransmitter GABA opposes excitation by promoting neuronal hyperpolarization

    Nerve Action Potential

    • A nerve action potential is a phenomenon characterized by the entry of sodium ions, leading to depolarization, and the efflux of potassium ions, leading to repolarization
    • This movement allows for the transmission of electrochemical current down the axon
    • Voltage-gated calcium channels are essential for releasing neurotransmitters at the synapse

    Neurophysiology of Neuronal Excitation in the CNS

    • Glutamate is the primary excitatory neurotransmitter in the central nervous system (CNS)
    • NMDA receptors allow calcium influx when stimulated by glutamate
    • AMPA receptors rapidly promote sodium influx when stimulated by glutamate
    • GABA is the primary inhibitory neurotransmitter , promoting chloride influx and hyperpolarization

    Regulation/Inhibition of Excitatory Activity in the CNS

    • GABA is the primary inhibitory neurotransmitter in the CNS, primarily via GABA (A) and GABA (B) receptors.
    • GABA(A) receptors allow chloride influx, causing hyperpolarization.
    • GABA(B) receptors impact presynaptic and postsynaptic functions indirectly by influencing cAMP and protein kinase A

    Biochemical Etiology of Seizures

    • Excessive excitation, decreased inhibition, and synchronization of neuronal firing contribute to seizures
    • Cellular energy failure from Hypoxia and oxidative damage and electrolyte abnormalities (like hyponatremia) can increase neuronal excitability and trigger seizures
    • Autoimmune diseases such as SLE can result in inflammation and altered neuronal function, thereby increasing seizure risk

    Important Neuroanatomical Locations

    • Seizures can originate and spread through various brain regions affecting sensory/motor systems and causing different symptoms
    • The frontal lobe encompasses sensory, motor and higher cognitive functions such as problem solving.
    • The parietal lobe deals with sensory reception and spatial awareness.
    • The occipital lobe deals with visual processing.
    • The temporal lobe encompasses auditory, memory, and speech processing
    • Sub-cortical areas like the thalamus and hippocampus, as well as the brainstem are related to autonomic and generalized seizures.

    Subtypes of Seizures

    • Focal seizures are restricted to one area of the brain; they can remain localized or spread
    • Generalized seizures involve both brain hemispheres.

    Status Epilepticus

    • Status epilepticus (SE) is a medical emergency entailing continuous seizure activity
    • SE presents as continuous seizure episodes without breaks, and can lead to serious consequences, including permanent neurologic damage.
    • Three subtypes of SE include generalized convulsive, nonconvulsive, and focal status epilepticus
    • Management of SE includes IV benzodiazepines (e.g., diazepam, lorazapam) to stop the acute seizure activity, along with anticonvulsant medication, to prevent future seizures.

    Pathophysiologic Etiologies of Seizures (Additional Information Included)

    • Various factors such as vascular, infectious, traumatic, autoimmune, metabolic, neoplastic, or drug-induced conditions can cause seizures
    • Specific examples are ischemic/hemorrhagic strokes, infections like meningitis or encephalitis, trauma, autoimmune conditions like SLE, metabolic disturbances, and tumors or masses (neoplasms)
    • The specific drugs that affect the seizure threshold include illicit drugs such as amphetamines, cocaine, and ketamine and, some prescribed medications such as antidepressants (like bupropion), and antipsychotics (like clozapine).
    • Several additional factors can contribute to the occurrence of seizures
    • For instance, sudden alcohol withdrawal, hypoglycemia, hyponatremia can trigger seizures.

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    Related Documents

    Pathophysiology of Seizures PDF

    Description

    Test your knowledge on the pathophysiology of seizures, nerve action potentials, and the neurophysiology of neuronal excitation in the central nervous system. Understand key concepts such as neurotransmitters and their functions, and the implications of neuronal hyperexcitability. This quiz will help reinforce essential principles in neurophysiology.

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