Drug Treatment of Epilepsy Flashcards
What are epileptic seizures?
Episodic high frequency discharges by a localised group of neurons in the brain
- They are not constantly occurring
- There are factors which decreases seizure threshold including stress and sleep deprivation
How do drugs in relation to epilepsy work?
to prevent excessive neurotransmission - whether that be increase excitation or increase inhibiton
Main Excitatory “ON” switch in the brain
Glutamate
Main Inhibitory “OFF” switch in the brain
GABA
Symptoms of Epilepsy depend on…
The area of the brain affected
- Motor Cortex → Convulsions
- Hypothalamus → Peripheral autonomic effects
- Reticular formation (Upper brainstem) → loss of consciousness
Why is determining the correct dosage of anti-epileptics essential?
Over medication can result in sedative effects including memory loss
The primary cause of epilepsy
Idiopathic
What is secondary epilepsy?
a result of brain damage which generally leads to seizures
What are partial seizures?
Also known as Local or Focal
Discharge is localised to one brain region and hemisphere
Can be Simple or Complex
Complex local seizure
Consciousness is affected (often the Temporal lobe)
What are generalised seizures?
Discharge involves both hemispheres and reticular systems - consciousness is affected
Can be differentiated to Absence Seizures or Tonic-Clonic
Absence Seizure
Also known as Petit Mal..
Most common in children: staring
Tonic-Clonic Seizures
Also known as Grand Mal
Tonic phase - muscle spasm, respiration stops, bowel/bladder discharge
Clonic phase - release
Physical signs - violent jerking, unable to stand
Main aims of antiepileptics
to reduce electrical excitability of excitatory neurons (i.e., glutamate) or to increase inhibitory neurotransmission (i.e., GABA)
4 Main Mechanisms of Antiepileptic Drugs
- Use-dependent Na+ channel block
- Ca2+ channel inhibition
- Increase GABA-mediated neural inhibition
- Inhibit glutaminergic