Week 5 - Epilepsy Flashcards
What are the 3 generalsied seizures?
- Typical absence
- No aura, brief
- Myoclonic
- Sudden, arm jerking, brief
- Tonic-clonic
- Sudden, 3 phases, headache after
What are the 3 phasses of a tonic-clonic seizure?
- Tonic phase with cyanosis
- Clonic phase
- Post-ictal phase
What is a generalise seizure?
One that simultaneously starts in both hemispheres
What is a focal seizure?
- Starts in focus then spreads
- Aura then loss of awareness
- Simple partial or complex partial (loss of consciousness)
- Temporal lobe seizure
- Aura
What is idiopathic epilepsy?
- No brain lesions
- No intellectual impairment
- Generalised seizures
- Controlled
What is symptomatic epilepsy?
- Lesion in brain or brain disorder
- Cognitive problems
- Abnormal MRI
- Uncontrolled seizures
What are the 3 causes of seizures?
- Neuronal over-excitement
- Epileptiform discharges
- Epileptogenesis
What happens during neuronal over-excitement?
- Non-gated ion channels
- Voltage-gated ion channels
- Glutamate excites neurons
- GABA inhibits neurons
What happens during epileptiform discharges?
- Neuronal bursting
- Seizure initiation
- Synaptic effects
- Glia effects
- Non-synaptic effects
- Seizure termination
What happens during epileptogenesis?
- Damage of brain leading to epilepsy
- Structural changes
- Molecular changes
- Functional changes
What happens during maximal electroshock seizure test?
- Application of electrical stimulus
- End-point = generalised tonic-clonic
- Test for anti-seizure activity against GTCs
How was PTZ tested on mice?
- Subcutaneous injection of convulsive dose
- Observe for clonic seizure
- Test for anti-seizure activity against nonconvulsice seizures
What is the importance of sodium channels in anti-epileptic drugs?
- The target for AEDs
- Some epilepsy caused by sodium channel mutation
- Mutation = gain or loss of channel function
- Some AEDs promote channel inhibition
- Some reduce GABA degradation or reuptake
What drugs worsen absence seizures and myoclonus seizures?
Carbamazepine / phenytoin
What are the main drugs used to treat epilepsy?
Any contraindications?
Valproate (facial deformaties if taken during pregnancy)
Levetiracetam
Benzodiazepines
Lamotrigine
