Epilepsy and Anti-epileptic Drugs Quiz

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Which statement best defines epilepsy?

Repeated seizures without recovery of consciousness between them, a pattern that is treated as an emergency. A sensory or psychic disturbance that occurs before loss of consciousness, sometimes forming the earliest part of a seizure. A single unprovoked tonic-clonic seizure lasting more than 5 minutes, a pattern that is treated as an emergency. Any episode of involuntary muscle contraction caused by abnormal cortical electrical activity, which may occur as part of a seizure. An enduring tendency to unprovoked seizures, usually demonstrated by two or more occurring more than 24 hours apart.

A Repeated seizures without recovery of consciousness between them, a pattern that is treated as an emergency.
B A sensory or psychic disturbance that occurs before loss of consciousness, sometimes forming the earliest part of a seizure.
C A single unprovoked tonic-clonic seizure lasting more than 5 minutes, a pattern that is treated as an emergency.
D Any episode of involuntary muscle contraction caused by abnormal cortical electrical activity, which may occur as part of a seizure.
E An enduring tendency to unprovoked seizures, usually demonstrated by two or more occurring more than 24 hours apart. ✓

The answer is E: An enduring tendency to unprovoked seizures, usually demonstrated by two or more occurring more than 24 hours apart.

Explanation

Why E is correct

See Definitions. Option E is correct. A seizure is a sudden, abnormal electrical discharge in the cortex of the brain that can cause sensory disturbance, movement, altered consciousness or autonomic features. Epilepsy is not a single seizure but an enduring predisposition to epileptic seizures: the brain has a lasting tendency to generate them. In practice the diagnosis is usually made after at least two unprovoked or reflex seizures more than 24 hours apart. An unprovoked seizure is one with no immediate trigger such as a low blood sugar or a head injury. The ILAE also allows a diagnosis after one unprovoked seizure if the risk of another over the next 10 years is at least 60%, or when an epilepsy syndrome is diagnosed. This separates epilepsy, a chronic condition, from a single provoked seizure. About 1 in 100 people in the UK have epilepsy. Status epilepticus is different: it is seizure activity lasting more than 5 minutes, or repeated seizures without recovery between them, and it is an emergency.

Seizure: A sudden, abnormal electrical discharge in the cortex.
Epilepsy: An enduring predisposition to unprovoked seizures.
Usual diagnosis: At least two unprovoked or reflex seizures more than 24 hours apart.
One seizure: Enough if the risk of another over 10 years is at least 60%, or an epilepsy syndrome is diagnosed.

Why the other options are incorrect

A. Repeated seizures without recovery of consciousness between them, a pattern that is treated as an emergency.: This also describes status epilepticus: repeated seizures without recovery of consciousness between them are treated as an emergency and do not define the underlying enduring tendency to seizures.
B. A sensory or psychic disturbance that occurs before loss of consciousness, sometimes forming the earliest part of a seizure.: This describes an aura, a sensory or psychic symptom that may precede or form the early part of a seizure; it is a feature within a seizure rather than the definition of epilepsy.
C. A single unprovoked tonic-clonic seizure lasting more than 5 minutes, a pattern that is treated as an emergency.: This describes status epilepticus: a single unprovoked tonic-clonic seizure lasting more than 5 minutes is an emergency, not the enduring tendency to seizures that defines epilepsy.
D. Any episode of involuntary muscle contraction caused by abnormal cortical electrical activity, which may occur as part of a seizure.: This describes a convulsion, which is the involuntary muscle-contraction component of some seizures; it can happen as a single event and does not by itself define the chronic condition epilepsy.

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More questions from this set. Start the quiz to answer them and see each explanation.

1
Which seizure class is defined by originating within, and rapidly engaging, networks distributed across both cerebral hemispheres?
2
Which antiseizure medicine is the first-line treatment for a child with absence seizures and no other seizure types?

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