Term
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Definition
| Sudden attack of involuntary muscular contractions and relaxations |
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Term
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Definition
| Abnormal central nervous system electrical activity |
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Term
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Definition
| A group of recurrent disorders of cerebral function characterized by both seizures and convulsions |
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Term
| Neurological disorder affecting the CNS |
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Definition
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Term
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Definition
| Excitatory (tells the neuron to fire) |
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Term
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Definition
| Inhibitory (dampens the neuron firing rate) |
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Term
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Definition
| Electrical signal that travels down the axon, and is created using sodium ions (Na+) and inhibited by potassium ions (K+) |
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Term
| Seizures occur when _______________ |
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Definition
| Excitatory and inhibitory processes dysfunction and abnormal electrical activity occurs (i.e. abnormal action potentials) |
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Term
| Simple Partial (focal) Seizures |
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Definition
Excessive electrical activity in ONE cerebral hemisphere
-Affects only part of the body
-Key feature: PRESERVATION OF CONSCIOUSNESS |
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Term
| Complex Partial (focal) Seizure |
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Definition
Excessive electrical activity in ONE cerebral hemisphere
LOSS OF AWARENESS at seizure onset. Person seems dazed/confused and exhibit meaningless behavior.
-Originate in FRONTAL or TEMPORAL lobes |
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Term
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Definition
Excessive electrical activity in BOTH cerebral hemispheres
LOSS OF CONSCIOUSNESS
-Originates in THALAMUS or BRAINSTEM
-Affects whole body, whole brain too |
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Term
| Generalized Seizures: Myoclonic |
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Definition
| Brief shock-like muscle jerks generalized or restricted to part of one extremity |
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Term
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Definition
| Sudden loss of muscle tone |
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Term
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Definition
| Sudden stiffening of the body, arms, or legs |
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Term
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Definition
| Rhythmic jerking movements of the arms and legs without a tonic component |
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Term
| GS: Tonic-clonic (grand mal) |
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Definition
Sudden stiffening followed by rhythmic jerking
Tonic phase followed by Clonic phase |
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Term
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Definition
Person appears to "blank out"/"Daydreaming"
-Simple absence (primarily affects consciousness only)
-Complex absence
-Atypical absence (including physical symptoms like eye blinking or lip movements) |
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Term
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Definition
A seizure lasting longer than 30 minutes, or 3 seizures without a normal period in between
-May be fatal (i.e. stops person from breathing)
-EMERGENCY INTERVENTION REQUIRED |
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Term
| Incidence of seizure types |
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Definition
Partial = 51%
Generalized = 38% |
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Term
1. Are seizures life threatening?
2. What stops the seizures?
3. What happens to breathing? |
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Definition
1. No
2. Brain
3. May cease for a few seconds |
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Term
1. Pain related to seizures?
2. Mental capacity after seizures? |
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Definition
1. No pain during seizures, muscle soreness may occur after
2. May be "different" for a while after seizure |
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Term
| Recurrent seizures that cannot be attributed to any cause are seen in patients with __________ |
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Definition
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Term
| Drug of choice depends on _____________ |
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Definition
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Term
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Definition
| Try to find a cause (i.e. fever, head trauma, drug abuse) |
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Term
| How many percentage of patients with epilepsy can have their seizures controlled with medication? |
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Definition
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Term
| Treatment: Monotherapy with anticonvulsant |
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Definition
-Increase dose gradually until seizures are controlled or adverse effects become unacceptable
-Multiple therapy may be required |
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Term
| Want to achieve _______________ with therapy |
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Definition
1. Achieve steady-state kinetics
2. Monitor plasma drug levels
3. Avoid sudden withdrawal |
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Term
| 3 MAIN MECHANISMS OF ACTION of Anti-convulsants |
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Definition
1. Inhibition of voltage-gated SODIUM (Na+)channels to show neuron firing
2. Enhancement of the inhibitory effects of the neurotransmitter GABA
3. Inhibition of CALCIUM channels |
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Term
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Definition
| THERE ARE MANY!! When treating a patient, need to know TYPE OF SEIZURE and what effects they can TOLERATE |
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Term
| Na+ channal inhibitor: PHENYTOIN (Dilantin, Phenytek) |
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Definition
First choice for partial and generalized tonic-clonic seizures
AE: GINGIVAL HYPERPLASIA (20-40%) treat by brushing teeth 8 times/day
-Primary reason not prescribed to children |
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Term
| Na+ channel inhibitors: ZONISAMIDE (Zonegran) |
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Definition
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Term
| Na+ Channel Inhibitor: LIDOCAINE |
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Definition
| Only used when other drugs are refractory for STATUS EPILEPTICUS |
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Term
| Enhancement of GABA inhibition: PHENOBARBITAL (Luminal) |
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Definition
Second choice for partial or generalized tonic-clonic seizures
-May cure one type of seizure but make another worse |
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Term
| Enhancement of GABA Inhibition: BENZODIAZEPINE |
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Definition
Diazepam (Valium) - VERY painful to inject
Lorazepam (Ativan) - NOT AS painful to inject |
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Term
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Definition
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Term
| Voltage-gated CA2+ Channel Blockers: ETHOSUXIMIDE (Zarontin) |
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Definition
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Term
| Blockade of CA2+ channels: GABAPENTIN (Neurotin) |
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Definition
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Term
| Other/Unknown MOA: Magnesium chloride |
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Definition
| Used for magnesium deficiency seizures |
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Term
| Other/Unknown MOA: PARALDEHYDE |
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Definition
| Alcohol withdrawal seizures |
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