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30 Cards in this Set

  • Front
  • Back
Name the two types of partial (focal) seizures and define.
SIMPLE PARTIAL: involves a focal neurological symptom that can be motor, sensory, or psychomotor. consciousness is always retained. COMPLEX PARTIAL: the initial focus of abnormal discharge spreads to both hemispheres (patient loses consciousness) and experiences postictal (postseizure) confusion. majority of complex originate in teh temporal lobe
Name the seizure that involves 1st a LOC, rigidity, loss of bowel and bladder, then jerking movements of the entire body.
Generalized Tonic-Clonic or Grand Mal seizure
Name the seizure that involves: usually children, very brief LOC, 3Hz spike-and-wave discharge on EEG, may occur dozens of times a day, and involves a low threshold of Ca2+ in the thalamic neurons.
absence seizures (Petite Mal)
Name the seizure that involves rhythmic jerking of all muscles, LOC, marked autonomic manifestations.
Clonic seizures
Name the seizure that involves non-rhythmic, rapid jerking with brief bursts of multiple spikes in the EEG.
myoclonic seizures
Name the epileptic syndrome that is characterized by brief recurrent myoclonic jerks fo the body with sudden flexion or extension of the body and limbs; attacks are fragmentary and often bilateral; also known as West Syndrome.
Infantile Spasms
Define Epilepsy.
group of chronic syndromes characterized by recurrent seizures with periods of consciousness.
Define seizures.
sudden,transitory, and uncontrolled episodes from abnormal discharging of neuronal cells with associated motor, sensory,or behavioral changes; excessive firing of neurons
Convulsions appear in what types of seizures?
all Generalized Tonic-Clonic Seizures and Simple Partial and Complex Partial Seizures if the focal neuronal discharge includes motor centers. Convulsion are MOTOR manifestations
Explain the tonic and clonic phases of the Grand mal or Generalized Tonic-Clonic seizure.
TONIC: sustained powerful muscle contraction (involves all body musculature) which arrests breathing. EEG: rhythmic high freq., high voltage discharges; CLONIC PHASE: alternating contraction and relaxation, EEG: groups of spikes and periodic neuronal depolarizations with clusters of action potentials.
The older epileptic drugs are targeted toward what?
Na+ channels blocking
The newer anti-epileptic drugs are targeting what?
Glutamate (NMDA, AMPA, Kainate) inhibitors and GABA agonists
What is the drug of choice for Partial seizures?
both simple and complex partial seizures are treated with Phenytoin and Carbamazepine; alternative options: valproic acid, phenobarbital, primidone
What is the drug of choice for absence seizures?
1st: Ethosuximide(inhibits Ca influx through T-type channels in thalamus) 2nd: Valproic Acid(inactivates Na+ and increases GABA; not to be used in children - possible hepatic failure)
What is the drug of choice for Myoclonic seizures?
Valproic acid (enhances GABA)
What is the primary treatment for status epilepticus?
use diazepam then phenytoin
What is the drug of choice for Febrile seizures in kids?
What is the drug of choice for Generalized Tonic Clonic (grand mal)?
Phenytoin or Valproic acid
Name this drug. the oldest anti-epileptic that's main S/E is sedation. MOA prolongs opening of Cl- channels, blocks GLU and Ca2+.
These drugs all inhibit vitamin K and may cause hemorrhage in a fetus.
Carbamazepine, Phenobarbital, Phenytoin, and Primidone (CP3)
Do not use these drugs during pregnancy for fear of congenital defects.
valproic acid (spina bifida), topiramate (limb agenesis and hypospadias) and zonisamide (teratogenic in animals)
These drugs not only induce the cytochrome P-450 mechanism and cause certain drugs (warfarin, vitamins, TCAs, theophylline, and steroid hormones) to become less potent (shorter T1/2), but they also cause vitamin K deficiencies.
Carbamazepine, Phenobarbaital, Phenytoin, and Primidone and cigarettes
These drugs cause an increase in availability of drugs that are metabolized by the P-450 system; aka. they inhibit the P-450 enzyme system.
erythromycin, verapamil, trimethoprim/sulfa, propoxyphene, cimetidine. - given with drugs that utilize the P-450 system can cause drug overdose
What are the anti-epileptic drugs main MOA?
to block the intitiation of abnormal electrical discharge and prevent the spread of abnormal discharge to other areas
Anti-epileptic drugs are used in many other neuropsychiatric disorders including:
tremor, spasticity, movement disorder; Migraines; Psychiatry; and Chronic pain
List the 3 Glutamate receptors in the brain.
NMDA, AMPA, and Kainate
Name the new AED that has many times replaced Carbamazepine because of less side-effects.
Lamotrigine (inhibits glutamate, blocks Na channels, prevents repetitive firing); however possible s/e is Stevens Johnson syndrome.
What benzodiazepine is efficacious in treating absence seizures and myoclonic seizures by increasing the frequency of Cl- channels? Its biggest S/E: sedation.
What is the main side-effect of benzodiazepines?
what is the difference in partial and generalized seizures?
partial start in one area (if its complex partial it will go from the focal area and migrate to both hemispheres and cause LOC); generalized start in both hemispheres and have LOC too