Anti-seizure Flashcards
Old antiepileptics
Carbamazepine, diazepam, ethusuximide, phenobarbital, phenytoin, valproic acid
New antiepileptics
gabapentin, tiagabine, lamotrigine, topiramate, levetiracetam, vigabatrin, oxcarbazepine, zonisamide, pregabalin
Seizure is
a transient alteration of behavior due to disordered, synchronous, rhythmic firing of brain neurons, can be nonepileptic (normal brain by electric shock/chemical convulsants) or epileptic (occurs without evident provocation), disorder of brain function with periodic unpredictable occurrence of seizures, specific treatment
Partial seizures
Begin focally, respond best to Carbamazepine, Phenytoin, Valproic acid, they are of two types: simple (preservation of consciousness and duration of 20-60 seconds), complex (imparted consciousness and duration of 30-120 seconds)
Generalized seizures
both hemispheres with impaired consciousness: absences when the patient is staring and stops any ongoing activity for less than 30 seconds (Ethusuximide, Valproic acid, Clonazepam); myoclonic (shock like contraction of muscles, only a group or whole body, for less than one second, treatment includes valproic acid or clonazepam); tonic-clonic seizures (60-120 seconds, treatment includes Carbamazepine, phenobarbital, phenytoin, valproic acid)
Single, first seizure
avoid typical precipitants (alcohol, sleep deprivation, stress).
More than one seizure (abnormal MRI, CT, EEG)
anticonvulsant therapy should be administered
Before introducing long term medication the discussion should be
risk of seizure recurrence, risk of adverse effects, benefits of avoiding another seizure; lifestyle precautions (Read more)
Medically refractory epilepsy
in case of failure to respond to three antiepileptic drugs, responds sometimes to immunotherapy (against autoantibodies developed to specific neutral antigen)
Treatment in status epilepticus
general therapy measures: removing objects from oral cavity, oxygen, 60 ml glucose 40% iv in case of hypoglycemia or to decrease temperature in case of fever, read more
after a seizure free period
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