Classifications
A transient occurence of signs and/or symptoms due to an abnormal excessive or synchronous neuronal activity in the brain
What is a seizure?
The lifetime incidence of seizures, and of epilepsy
What are 11% and 3%?
These two Barbiturates enhance GABA synaptic transmissions in two different mechanisms
What are Pentobarbital and Vigabatrin?
This medication can cause psychosis, depression, hostility, aggressive behavior and is metabolized by CYP450: 3A4/5
What is Perampanel?
The culmination of building abnormal cortical activity
What is the ictus?
A chronic disorder of the brain characterized by recurrent seizures or a single seizure with the propensity to have another
What is epilepsy?
The age group with the high incidence of new cases of epilepsy
What is patients over 70?
This is the common mechanism of phenytoin, carbamazepine, lamotrigine, topiramate, valproic acid and zonisamide
What is prolonging fast inactivation of voltage gated sodium channels?
This medication that prolongs fast inactivation of voltage gated sodium channels can also cause closed angle glaucoma
What is Topiramate?
These include sense of fear, premonition, deja vu, gastric upset, abnormal smeels, or the sense that something is about to happen
What are auras?
Patient falls to the ground with a further loss of consciousness in which all extremities are extended and rigid, and jerks of all the limbs are displayed.
What is generalized seizure?
These include prenatal or birth injury, inborn error of metabolism, congenital malformation, Idiopathic/genetic syndromes, CNS infections and trauma
What are common causes of infantile and childhood seizures?
These drugs potentiate GABA’s ability to open the GABAA Cl- channel (increase channel opening frequency)
What are the Benzodizepines Clonazepam and Clobazam?
A 32 year old man is prescribed a drug that inhibits the breakdown of GABA. Apart from somnolence, headache, dizziness, diplopia, ataxia and GI disturbances, he may present with these side effects that could affect his mood
What are nervousness, depression, and memory disturbances?
The most common characteristics of a patient in a post-ictal state
What are fatigue, lethargy, disorientation with limited cognitive ability and somnolence?
Patient is confused and displays episodes such as grimacing, squirming, and flailing of the limbs; side-to-side movement of the head; and resistance and even thrashing at anyone attempting to assist him. The patient displays no aura.
What is a psychogenic seizure?
Common causes of seizures in adolescents and young adults
What are head trauma, drug intoxication and withdrawal?
This drug works on sodium channels, but does not prolong fast inactivation
What is Lacosamide?
A 23 year old woman that suffers from seizures wants to get pregnant but she is allergic to all seizure medications except those that work by inactivation of Na+ channels.
These medications are safe for her to use
These are not
What are Lamotrigine, Lacosamide, and Zonisamide?
What are Carbamazepine, Phenytoin, Topiramate, and Valproic acid?
Persistent weakness of an affected limb after a seizure
What is Todd's paralysis?
Patient immediately lost consciousness and began having twitching of his left hand, followed quickly by twitching of his left arm and left side of his mouth. Within 5 seconds, he had tonic-clonic movements of all 4 extremities.
What is a complex partial with secondary generalization?
Common causes of seizures in older adults
What are stroke, brain tumor, acute metabolic disturbances, and neurodegenerative diseases?
A 9-year-old child is having learning difficulties at school. He has brief lapses of awareness with eyelid fluttering that occur every 5-10 minutes. EEG studies reveal brief 3-Hz spike and wave discharges appearing synchronously in all leads. The 6 mechanisms of drugs that may be used to treat him are:
What are:
Inactivation of NA+ channels
Enhanced GABA Synaptic Transmissions
Limit the activation of T current Voltage gated CA2+ channels.
Inhibits Vesicular release of neurotransmitters
Blocks the open state of Glutamate NMDA channel
Using a non competitive glutamate AMPA Receptor antagonist
A 24 year old male has been taking DRUG A that is metabolized by CYP2C9.
He starts to take an anticonvulsant medication that decreases the effects of DRUG A.
His doctor changed his medication, and now he starts to take a second anticonvulsant that increases the effects of DRUG A.
Respectively these drugs are most likely to be:
What are Carbamazepine or Phenytoin followed by Valproic acid?
Important characteristics of seizures to remember for a differential diagnosis
What are that seizures are paroxysmal, usually independent of environmental triggers, and stereotypic?