Seizures

Question 1

• Partial treatment drugs? (3)
• Tonic Clonic? (3)
• Atonic/myoclonic (3)
• Absence? (2)
• Focal due to? (3)
• Synch due to? (3)
• Propogation due to? (2)
• Inhibits VSSC via dose dependent blockade? (4)
• Decrease threshold of T-Type Ca? (2)
• Inhibit high voltage Ca?
• Inhibit synaptic vessicle SV2A release?
• Increase GABA: BDZ/phenobarb? vigabartin? tiagabine? gabapentin?

Answer 1

• Cabamazepine; Levitiracetam; Lamotrigine
• Valproate; Levitiracetam; Lamotrigine
• Valproate; Levitiracetam; Lamotrigine
• Ethosuximide; Valproate
• Ab voltage gated; Low GABA; High glu
• Low GABA; High GLu; Altered EC
• Recruitment; Altered EC
• Phenytoin; Carb., Lamo., valproate
• Etho, valproate
• Lamo
• levet
• Increase opening, Inhibits GABA-transaminase, Blocks reuptake, Alters GABA chem,

Question 2

Old Drugs:
1.) Carbamazepine: Use? (2) Inducer of? SE? (4)
2.) Phenytoin: Use? Kinetics? Induces? SE? (5)
New Drugs:
1.) Lamotrigine: Use? Effects? Same SE’s as?
2.) Levetiracetam: 1st line for? CYP450? SE? (2)
3.) Ethosuximide: Use? Some dose related?
4.) Valproate: Use? Pregnancy? Coated? Inhibits what? SE? (3)
5.) Phenobarbital: Use? Classic?

Answer 2

1. ) Partial/ tonic clonic; CYP450; diploplia, ataxia, aplastic, hepatotoxicity
2. ) Partial/Tonic; 0 order; CYP450; Nystagmus, dip., ataxia, rash, osteomalacia
3. ) Partial/general; VSSC, VSCC; phenytoin
4. ) Tonic Clonic; No; asthenia, somnelence
5. ) Absence; GI
6. ) Broad; NO; enteric; metab of other AED’s; weight gain, hepatic, pancreatitis
7. ) Neonatal Status Ep; inducer of CYP450

Question 3

• Order of GABA inhibition? (4)
• 2 general? 3 partial?
• Status Epilecticus treated how?
• Pregnancy: Vit K needed with? (3) Folic needed with? (2)
• How many have seizure? Prev. of epilepsy?
• Problem of? Effects who?
  Partial: Consciousness not impaired? Usually 1 min, hippo involved and most common type? Common in adults, starts in one area and spreads to tonic clonic?
  Generalized: Rapid musc. contractions? Most common violent jerking? Brief staring periods?

Answer 3

• Hypnotic, Anxiolytic, anti conv., coma
• Absence/tonic clonic; simple, complex, 2nd gen
• BDZ’s lorazapam
• Phenytoin; carb., phenobarb; val and carb
• 10%; 0.7%
• Simple; complex; 2ndary generalized
• Myoclonic; tonic clonic, absense

Question 4

• Complex partial vs absence?
• 3 possible etiologies?
• Intractable? Non med options? (3)
• Status epilecticus?
• Febrile seizures? Not due to?
• Lennox Gastauts?

Answer 4

• partial complex followed by postictal state
• symptomatic, idiopathic, cryptogenic
• Don’t respond to 3+ treatments; ketogenic diet, vagal nerve stim, surgery
• medical emergency, continuous EEG seizure
• Convulsion triggered by fever; not due to infection of brain/spinal cord
• Intractable seizure disorder