Epilepsy Flashcards
Why are anti-epileptic drugs (AEDs) a problem with pregnant women?
They can cause neural tube defects
What should a women taking AEDs be taking aswell?
5mg Folic acid daily
Can women on AEDs take the contraceptive pill?
They should avoid them as the drug interaction can cause failure of the pill
What surgical treatment should a drug resistant patient have?
- Temporal lobe resection
- Extratemporal resection
- Hemispherectomy
- Corpus callosotomy
- Vagus nerve stimulation
What are the causes of seizures?
- Brain tumour
- Cerebral infarction
- Cerebral haemorrhage
- Cerebral venous thrombosis
- Arteriovenous malformation
- Head injury
What neurological diseases might seizures be associated with?
- Meningitis
- Encephalitis
- Neurogenerative diseases
- Alcohol, drugs and toxins
- Metabolic and biochemical disorders
What are the 2 types of seizures?
- Generalised seizures discharges and simultaneous and involve both cerebral hemispheres
- Partial (Focal): seizures discharges originates from a localised part of the cerebral hemisphere
What are the symptoms of a partial seizure?
Motor
- Rhythmic twitching in one part of the body
- Sustained tonic or dystonic movement of one limb and with head with eyes turning
Sensory
- Tingling or numbness affecting one part of the body
High Cortical Function
- Dysphasic symptoms
- Disturbance of memory in a form of flashbacks, deja vu, fear anger
- Visual, auditory or olfactory symptoms can occur
What is a simple focal aware seizure?
- Consciousness is impaired
What is a complex focal impaired aware seizure?
Consciousness is impaired
What are the symptoms of a generalised tonic clonic seizure?
Tonic phase
- patients may cry then fall
- becoming rigid with jaw clenching
- Breath holding and froth coming out of the mouth
- Could last for seconds
Clonic phase
- Rhythmic clonic jerking of the limbs, neck and back
- Tongue biting
- Urinary incontinence
- could last for minutes
What is the main drug treatment of epilepsy?
Anticonvulsants
What are the main pharmacological mechanisms of AEDs?
- Increase inhibitory neurotransmitter - GABA (direct agonists, decrease breakdown, inihibit reuptake)
- Decrease excitatory neurotransmitter - glutamate
- Block voltage inward currents - Na and Ca
Many AEDs are pleiotropic (act via multiple mechanisms)
What are the actions of barbiturates?
Increase GABA
What are the actions of Benzodiazepines?
Increase GABA
