Sezuires Flashcards
Generalised sezuire
Involves both hemisoheres
Widespread synchronisation
Sezuires
Brief loss of conciousness
Perception of odours
Confusion
Bizare behaviours
Types of generalised sezuires
Absence Atonic drop Clonic Myclonic Generalised tonic clonic
Absence sezuire
Petit mal
Brief lapse of conciousness
Atonic drop
Gen
Sudden loss of posture
Brief invol muscle twitch
Clonic
Repetitive jerking, 1 min
Myoclonic
Single rapid twitch event
Generalised tonic clonic
Grand mal Immediate deep loss of conciousness Tonic phase of rigid muscle contraction Clonic phase of violent jerking As a consequence of focal sezuire spreading
Focal sezuire
Localised synchronisation in a sezuire focus
Symptoms reflect brain area they occur in
Can become generalised
Symptoms of focal sezuires
Deja vu
Temporal lobe epilepsy
Focal motor sezuires
Vulnerable brain areas=temporal lobe and motor cortex
Jacksonian sezuire
Starts in fingers, travels up arm, frontal lobe epilepsy
Causes of epilepsy
High fever Head injury Stroke Tumour Alcohol withdrawl Genetic abnormalisties Development abnorm Chronic illness
Usually due to imbalance between excitatory and inhibitory neuronal activity
What can make absence epilepsies worse?
Gabaa drugs
Increase synchronisation of t type ca channels in bs
Whats the general treatment for partial sezuires
Gaba a levels/r or na channel drugs
Decrease excitation increase inhibition
Sodium channel inaxtivator
Partial sezuire treatment
Stabilises inactivated state of vg sodium channels
Reduces sustained firing of neurones
Significant side effects
Phenytoin
Sodium channel inactivator
Partial sezuire treatment
Carbamazepine
Sodium channel inactivator
Partial sezuire treatment
Oxcarbazepine
Sodium channel inactivator
Partial sezuire treatment
Iamotrigine
Sodium channel inactivator
Partial sezuire treatment
Topiramate
Sodium channel inactivator
Partial sezuire treatment
Felbamate
Sodium channel inactivator
Partial sezuire treatment
Gaba a enhancers
Benzos , channel open for longer, engog gaba
Phenobarbital, does not need endog gaba, limited use except in status epilepticus and refractory epilepsy
Produce tollerance, sedation, confusion and dependence
Diazepam
Benzo
Vigabatrin
Phenobarbital
Inhibit breakdown of gaba by gaba tansaminase
Tiagabine
Inhibits gaba uptake by gaba transporter
Gabapentin and pregabalin
Bind to gabars
Decrease gaba uptake
Increase gaba release
Increase gaba synthesis
Zonisamide
Partial sezuires
Gabaa rs inhibit reuptake
Levitiracetam
Cyclic gaba derivative
Unknown mech
Bind vesicle protein sva2? Inhibiting exocytosis
Bind to calcium channel to decrease neurotransmission?
Generalised sezuire treatment
Calcium channel blocking
Ethosuximide
Blocks t type ca channels that cause synchronisation in absence sezuires
