Epilepsy

Question 1

Epilepsy

Answer 1

A common disorder characterised by seizures

Due to uncontrolled electrochemical signalling and neuronal discharges

Often no recognisable cause

Question 2

Jacksonian epilepsy

Answer 2

Partial seizures

Focused in the motor cortex, leading to repetitive involuntary jerking of a muscle group

Question 3

Psychomotor epilepsy

Answer 3

Partial seizures

Focused in the temportal lobe, leading to purposed movements

Lasts only a few minutes

Question 4

Tonic-clonic epilepsy

Answer 4

Generalised seizures

Two-phases
Initial strong contraction of all muscles (including interruption of respiration) followed by a series of violent jerks

Question 5

Absence seizure

Answer 5

Generalised seizures

Common in children

Oscilating feedback between the cortex and thalamus leads to an abrupt cease in activity

Question 6

Lennox-Gastaut

Answer 6

Generalised seizures

Occurs in children

Most severe, associated with neurodegeneration leading to mental retardation

Question 7

Aetiology of epilepsy

Answer 7

The aetiology of epilepsy is poorly understood

May be due to increased excitatory transmission or decreased inhibitory transmission

Question 8

Benzodiazepines

Answer 8

Effective in acute seizures in children

Lead to enhanced GABA(A) activation

Leads to hyperpolarisation of the cell, hence reducing neuronal activity

Question 9

Vigabatrin

Answer 9

Effective in all types of epilepsy

Irreversible inhibitor of GABA transaminase

Inhibits GABA breakdown, increasing levels of GABA in the synapse

Question 10

Tiagabine

Answer 10

Used as an add-on therapy for partial seizures

Inhibit the GAT1 reuptake transporter, increasing levels of GABA in the synapse

Question 11

Carbamazepine

Answer 11

Used for all types of epilepsy, except absence seizures

Partially inhibits sodium channel function

Voltage dependent; only blocking the sodium channel when it is in se

Question 12

Ethosuximide

Answer 12

T-type calcium channel inhibitor

Transiently blocks the channel, mediating calcium influx

Question 13

Galapentin

Answer 13

P/Q type calcium channel inhibitor

Binds to a subunit of the channel, preventing traffic to the plasma membrane

Question 14

Valproate

Answer 14

Used in all types of epilepsy

• Weak GABA transaminase inhibitor
• Weak GABA(A) agonist
• T-type calcium channel inhibitor
• Sodium channel inhibitor