Antiseizure Drugs

Question 1

The symptoms of a focal seizure is determined by …..

Answer 1

Site of neuronal discharge
The extent to which electrical activity spreads to other neurons in the brain.

Question 2

The symptoms of a focal seizure is determined by …..

Answer 2

Site of neuronal discharge
The extent to which electrical activity spreads to other neurons in the brain.

Question 3

Classify seizure

Answer 3

Focal seizure
Focal Impaired awareness
Focal aware seizure
Focal - bilateral clonic tonic seizure ( formerly secondarily generalized seizure)

Generalised seizure ( loss of consciousness)
Tonic-clonic
Clonic
Tonic
Myoclonic
Absence
Atonic

Epilepsy
Recurrent seizure

Question 4

What are the features of generalized seizures

Answer 4

They may begin locally and spread
Convulsive or non convulsive
There is usually an immediate loss of consciousness

Question 5

Characteristics of grand mal seizure

Answer 5

Loc
Tonic clonic contractions
State of confusion or exhaustion due to energy and glucose depletion

Question 6

Features of petit mal or absence seizure

Answer 6

Occurs at 3_5 years old
Can progress to puberty and beyond
Seen in epileptic encephalopathy
Lennoxtown gastaut syndrome and absence epilepsy

Rapid eye blinking
Very distinct 3s spike and wave discharge on EEG

Question 7

An infant experiences a seizure upon diagnosis he was found to have a mutation in the SCN 1A gene what form of epilepsy is this

Answer 7

Myoclonic seizure

Question 8

Myoclonic seizure is seen in

Answer 8

Juvenile Myoclonic epilepsy
Dravet syndrome

Question 9

Features of myoglobin seizure

Answer 9

Seen in juvenile or infancy epileptic syndromes
Occurs as a result of genetic mutation in SCN1 A
Onset: puberty or early adulthood
Jerry movements

Question 10

What limits the use of benzodiazepines in the treatment of chronic seizures and epilepsy

Answer 10

Tolerance
Sedative effects

Paradoxical hyperactivity in children
Used in emergency or acute seizures

Question 11

Diazepam mode of administration and usage

Answer 11

IV- first-line treatment for status epilepticus

Rectal and intranasal gel- acute repetitive seizure and generalized tonic-clonic seizure where oral administration is not possible

Question 12

…………. is a long-acting potent benzodiazepam

Answer 12

Clonazepam

Question 13

…………. is preferred in the treatment of out of hospital treatment of status epilepticus

Answer 13

IM imidazole

Question 14

Lorazepam is used in the treatment of …….

Answer 14

Status epilepticus

Question 15

Clorazepate dipotassium is used in treatment of ……….

Answer 15

Focal seizures

Question 16

MOA of valproic acid

Answer 16

Voltage gated Na channel blockade
GABA T blockade
Ca 2+ channel blockade
Reduces the amplitude of NMDA at NMDA receptor in a dose dependent manner

Question 17

Valproate drug interactions

Answer 17

Inhibits carbamazepine clearance
Carbamazepine epoxide carbamazepine’s active metabolite increase
Inhibits metabolism of the CYP29 UGT and epoxide hydrolase system

Question 18

Carbamezepine indications and contraindications

Answer 18

Indications: focal seizure
Focal to bilateral clonic-tonic seizure
Grand mal seizure

Contraindications
Myogenic
Absence
Other idiopathic generalized seizure as it can result in increased seizure