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Neuropsychopharmacology > Epilepsy and its Treatment > Flashcards

Epilepsy and its Treatment Flashcards

1
Q

What is epilepsy?

A

A group of CNS disorders in which recurrent seizures occur due to chronic underlying processes, affecting motor, sensory and autonomic outputs

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2
Q

What are idiopathic seizures?

A

cannot be ascribed to a particular cause i.e. benign neonatal convulsions

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3
Q

What are secondary seizures?

A

associated with an illness, trauma, neoplasm, infection or developmental abnormality i.e West Syndrom

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4
Q

How are epilepsies classified?

A

The locus of the epilepsy: Generalised or focal

The basis of aetiology : idiopathic or symptomatic

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5
Q

How is an EEG used to record brain waves?

A

records brain waves to detect spikes, rhythms etc can be used to view things like sleep cycles as well as epilepsy

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6
Q

What are the different types of partial seizure?

A

simple - no impaired consciousness
complex - confusion, stumbling and consciousness impaired
partial with secondary generalisation
synchronicity confined to one brain region

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7
Q

What are the different types of generalised seizure?

A

tonic-clonic - tonic rigidity followed by tremor, clonic phase results in relaxations causing jerking
absence - altered conciousness with a few mild clonic spasms, only 10-45s but can happen alot throughout day
Myoclonic - isolated clonic jerks
Atonic - sudden loss of posture leading to collapse
Infantile Spasms - bilateral myoclonic jerks, before 12months

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8
Q

What is status epilepticus?

A

term given to continuous seizures lasting more than 30mins where inadequate treatment can result in brain damage or death

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9
Q

What can cause status epilepticus?

A

non-compliance, suffering from fever, infection, hypoxia, encephalitis, subarachnoid haemorrhage, or sudden withdrawal from sedatives, or BDZs

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10
Q

What does the initiation of a seizure involve?

A

high frequency bursts of APs

hypersynchronicity

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11
Q

How might other neurons be recruited in a seizure?

A

Increase EC K+ depolarises surrounding neurons
Accumulation of Ca in presynaptic terminals enhance NT
Depolarisation induced activation of NMDA receptors resulting in Ca influx

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12
Q

How can we make experimental models of epilepsy?

A

Maximal electric shock test - partial and tonic
PT2 - pentylenetetrazol induced seizures - generalised absence seizures
Lethargic, star-gazer and tottering mutant mice - generalised
Minimal metrazol induced seizures - thought to model myoclonic seizures in humans

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13
Q

What are some of the channelopathies associated with Epilepsy?

A

nAChRa7 - juvenile myoclonic
nAChRa4b2 - autosomal dominant nocturnal FL epilepsy
GABAaRa1,y2,d - generalised epilepsy with febrile seizures
Na - Channels
K - channels

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14
Q

What do neurons need to produce GABA?

A

GAD

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15
Q

How is glutamine synthesised to glutamate?

A

glutaminase

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16
Q

What are treatments aimed at in treating epilepsy?

A

interfering with the metabolism of GABA

17
Q

How are BDZs used in epilepsy and what are their features?

A

Used for stopping status epilepticus
Clonazepam - absence and tonic-clonic
enhance affinity for GABA

18
Q

What are the possible drugs for use in treatment of epilepsy?

A 
Phenytoin
Carbamazepine
Valproate
Ethosuxamide
Lamotrigine
Topiramate
Gabapentin
Vigabatrin
19
Q

What are the features of phenytoin?

A

blocks tetanic firing by increasing Na channel inactivation

reduces NT release

20
Q

What are the features of carbamazepine?

A

acts like phenytoin and also potentiates GABA responses

is also a tricyclic antidepressant

21
Q

What are the features of valproate?

A

acts like phenytoin and reduces Ca-T-type activity and increases GABA levels by inhibiting breakdown
used in absence seizures

22
Q

What are the features of Ethosuxamide?

A

inhibits T-Ca-Channel activity in thalamic neurons

used in absence and myoclonic seizures

23
Q

What are the features of Lamotrigine?

A

blocks Na channels
inhibits release of excitatory amino acids
phenytoin and carbamezapine reduce the half life
valproate prolongs half life
rashes in children

24
Q

What are the features of Topiramate?

A

similar to phenytoin and carbamezapine also inhibits kainate receptors and enhances GABA

25
Q

What are the features of Gabapentin?

A

elevates GABA and binds to Ca channel subunit
used for partial with or without secondary generalisation
few drug interactions - cimitedine

26
Q

What are the features of vigabatrin?

A

inibits GABA-T
used to treat partial seizures
psychosis is a rare side-effect

Neuropsychopharmacology (8 decks)

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