232: Epilepsy Flashcards
Features of Juvenile Myoclonic Epilepsy
Early tell tail signs before epilepsy diagnosed nearer adulthood. Daydreamer in school, jerks as a teenager, worsening in the am, an episode of LOC - presumed to be hypoglycemia.
Features of generalised tonic-clonic seizure
sudden onset, tonic stiffness, synchronous clonic movements, cyanosis ( autonomic dysruption), sertorous breathing, lateral tongue biting incontinence, post-ictal period (v.tired)
Features of temporal lobe seizure (partial complex)
Aura :rising epigastric, olfactory, psychic (depersonalisation/derealism/deja vu) , limbic (fear). Arrest -motor and speech. Automatism ( manual or oro-facial) lasts 2-10 min post-ictal - confusion.
Non-epileptic seizure features…
awareness retained gradual onset prolongued frequent asynchronous movements back arching bite tip of tounge
Causes non epileptic attach disorder (NEAD)
psychologically mediated - traumatic childhood experiences.
Name some voltage gated Na blockers (glutamate)
carbamazepine, phenytoin, valproic acid, lamotrigine, topiramate, rufinamide
how does levatiracetam work?
SV2A receptor blocker ( glutamate synaptic vesicle)
how does topiramate work?
AMPA and kinate receptor blocker ( on post synaptic neurone) and GABA uptake modulater
how does felbamate work ?
NMDA receptor blocker (glutamate) on post synaptice neurone
how do gabapentin and pregabalin work?
Ca channel blocker pre synapse ( glutamate)
how does Vigabatrin work?
inhibits GABA transanimase (GABA accumulates)
how does tiagabine work
GABA reuptake inhibitor ( blocks GAT1)
how do benzodiazepines work?
enhances effects of GABA on post synaptic receptor
how do felbamate, topiramate and zonisamide work?
modulates GABA and Blocks NMDA reeptor
how doe barbiturates work?
enhances the effect of GABA and block glutamate AMPA receptor and Ca Channels
