Epilepsy, Seizures and Anti-seizure Drugs

Question 1

What is the cause of primary epilepsy?

Answer 1

Cause is unknown

Question 2

What is the cause of secondary epilepsy?

Answer 2

Cause is related to a particular event (TBI/stroke)

Question 3

Epilepsy

Answer 3

Sudden excessive electrical discharge from large groups of neurons

Neurons are tonically depolarized and fire continuously at high freq (tonic phase/mm spasms) followed by phasic re-polarization interruption (clonic phase) and gradual return to normal membrane potentials

Question 4

Generalized Seizures

Answer 4

Involve both hemispheres (depol in thal and substantia nigra)

Question 5

Complex Seizures

Answer 5

Loss of consciousness (temporal/limbic lobe)

Question 6

Partial Seizures

Answer 6

Originate in localized area of 1 cerebral hemisphere

Drug of Choice: Carbameazepine

Question 7

Simple Seizure

Answer 7

Consciousness is intact

Question 8

Simple Partial Seizure

Answer 8

Unilateral hemispheric involvement, no impaired consciousness. Jerking commonly in face/arm/leg, “fencer’s posture”, may have hallucinations of sigh, hearing or taste, ANS response nausea, pallor/flushing, pupillary dilation

Question 9

Complex Partial Seizure

Answer 9

Localized onset that progresses to bilateral involvement, impaired consciousness. Amnesic about event, see clumsy perseveration of ongoing motor events (chewing, drawing, walking, hand rubbing)

Question 10

Tonic-Clonic Seizure (grand-mal)

Answer 10

Sudden loss of consciousness, sudden extensor spasm followed by flexor spasm, respiration ceases, defecation, micturation or salvation may occur. Alertness slowly returns w/period of confusion.

Drug of choice: Dilantin

Question 11

Absence Sizures (petit mal)

Answer 11

Occur freq in children and disappear in adolescence, abrupt brief loss of consciousness w/ amnesia. Stares blankly for a few minutes.

Drug of Choice: Depakote

Question 12

Myoclonic Seizures

Answer 12

Single contraction or multiple sudden brief contractions confined to face, trunk, or extremities lasing only seconds

Drug of Choice: Depakote

Question 13

Atonic Seizures

Answer 13

Often in kids, drop attacks, a sudden reduction in mm tone, brief loss of consciousness

Question 14

Status Epilepticus

Answer 14

Seizures are prolonged or repeated that recovery doesn’t occur btw attacks=medical emergency!

Question 15

Main mechanism of action for current antieplieptic drugs (AED)

Answer 15

Enhancement of GABA activity and the blockade of the voltage gated Na and Ca channels

Question 16

Side effect of AED

Answer 16

Drowsiness, ATAXIA, nystagmus, vertigo, skin rash, cognitive disorders, neg implications w/motor learning

Question 17

Dilantin (my ant named dil has seizures)

Answer 17

Primary drug for seizure control (-absence seizure), alters conductance of K and Ca channels and blocks Na channel

Question 18

Carbamazepine (eat a lot of carbs b/c you burn a lot of kcals wehn you seizure)

Answer 18

Second most common AED, drug of choice for partial seizures

-blocks Na channels and Ca uptake

Question 19

Depakote (when you seizure you defecate (depakote)

Answer 19

Increases synthesis of GABA in synapse and prevents GABA re-uptake

Question 20

These drugs can induce seizures

Answer 20

ketamine, cocaine