Procedures
This neurosurgical procedure is the most common destructive surgical treatment for epilepsy.
What is the anterior temporal lobectomy (ATL)?
________ is an electrical disorder characterized by neural cell hypersynchrony.
What is epilepsy?
This type of epliepsy is associated with a history of febrile seizures as an infant or toddler.
What is temporal lobe epilepsy?
This is the strongest predictor of diminished quality of life in epilepsy.
What is depression?
A focal seizure in this lobe of the brain may result in transient motor symptoms such as bicycling or sometimes speech arrest.
What is/ are the frontal lobe(s)?
These are two of the FDA-approved forms of neuromodulation used in treatment of epilepsy.
What are [any two of the following]?
RNS
DBS
VNS
These are the three major seizure types.
What are focal onset, generalized onset, and unknown onset?
Globally, approximately this many people are diagnosed with epilepsy each year.
What is 5 million?
Ictal weeping, a history of PTSD or borderline personality disorder, and rapid normalization of cognition after signs of seizure should clue you into this etiology.
What is PNES/PNEE?
Combined visual and oculomotor phenomena may suggest seizures arising from this lobe, but is not highly specific.
What is the occipital lobe?
This procedure involves injecting a fast-acting barbiturate into each hemisphere of the brain in order to test functions of the other hemisphere.
What is a Wada test? Analogous or more-specific names are also acceptable.
Side-note: The test is named after Japanese-Canadian neurologist June Wada who pioneered the procedure although it is often written incorrectly as WADA.
Per ILAE guidelines, epilepsy is diagnosed after a person experiences ___ or more ___ seizures greater than 24 hours apart, one unprovoked seizures with high recurrence risk, or identification of an epilepsy syndrome.
What are two unprovoked?
These two cognitive domains are most-commonly affected in temporal lobe epilepsy, among those with frequent or long-duration seizures.
What are verbal learning/ memory and language functions?
This self-report instrument evaluates domains such as seizure worry, cognitive functioning, medication side-effects, and social functioning; and is commonly used in presurgical epilepsy evaluations.
What is the QOLIE?
Samantha's first seizure symptom is a numbness/ tingling sensation in her right face and arm. Seizures are most-likely arising from this brain region.
What is the left parietal lobe/ left somatosensory cortex?
Both side and lobe required for points.
sEEG stands for this.
What is stereoelectroencephalography?
Stereotactic electroencephalography is also acceptable.
Billy presents to the clinic with his family. His wife shows you a video of him on the floor with eyes closed, back-and-forth head movements, and pelvic thrusting. Before sending him for an EMU evaluation, you discern that his symptoms are most likely to be classified as this.
What is PNES/PNEE, etc.?
DAILY DOUBLE 1!!!
What is the Epilepsy Foundation?
This neurologic condition is associated with an increased risk of PNES/PNEE.
What is epilepsy?
Johnny experiences a generalized seizure with head deviation to the right and figure of four posture with his right arm extended. This is the hemisphere and lobe most likely involved.
What is left temporal?
both aspects required for points
This procedure involving multiple small parallel cuts in the cortex disrupts horizontal fibers to interrupt seizure propagation and is implemented when seizures arise from a brain region that is unsafe to resect. It is used less-often due to low efficacy relative to other options such as neuromodulation.
What is multiple subpial transection?
According to the ILAE, this "is a condition resulting either from the failure of the mechanisms responsible for seizure termination or from the initiation of mechanisms, which lead to abnormally, prolonged seizures (after time point t1). It is a condition, which can have long-term consequences (after time point t2), including neuronal death, neuronal injury, and alteration of neuronal networks, depending on the type and duration of seizures"
What is status epilepticus?
Per the LaFrance criteria, this is the "diagnostic level" label given after observed symptoms "by clinician experienced in diagnosis of seizure disorders, showing semiology typical of PNES, while on video EEG."
What is Documented PNES/PNEE?
Daily Double 2!!!
What is "figure 4" sign, posture, etc.?
Temporal lobe seizures have been ruled out. The patient experiences an epigastric rising sensation as part of her semiology. Seizures are most-likely arising from this brain region.
What is the insula?