Transcript Definition – paroxysmal events thought to represent abnormal

Pathogenesis
- usually idiopathic
- other causes
Classification of seizures
Generalized seizures
- tonic-clonic (grand mal)
- myoclonic
- tonic
- atonic
- absence (petit mal)
- infantile
- atypical absence
spasms
Differential diagnosis:
-Syncope
-Vertigo
-Tics
-Psychogenic symptoms
-Breath holding spells
-Reflux in infants
Plan/Management
-Status epilepticus requires transport
to ED
-Refer to neurologist for accurate
classification of seizure type
-Monotherapy over polytherapy
-Monitor CBC, LFTs, drug levels
-Treatment for 2 years (seizure free)
Partial seizures 
Oxcarbazepine
Carbamazepine
Phenytoin
Phenobarbital
Levetiracetam
Lamotrigine
Topiramate
•
•
•
•
•
•
•
Absence seizures 
Ethosuximide •
Valproic acid •
Tonic-Clinic 
Seizures
Phenytoin
Valproic acid
Carbamazepine
Topiramate
Levetiracetam
•
•
•
•
•
Myoclonic and 
Atonic Seizures
Clonazepam •
Lamotrigine •
- Levetiracetam
Infantile Spasms
ACTH Topamax -
Used for seizures longer than 5 minutes 
in length or for clusters of seizures
Goal of pharmacologic treatment:
seizure control without adverse
effects