Transcript EPILEPSY AND ANTI-SEIZURE DRUGS • SEIZURES • TYPES OF

Tobias Milz

synchronous, high frequency
discharge of neurons from cortical or
subcortical centres
sudden change in behavior characterized by
changes in sensory perception or motor activity
 result
of extreme metabolic disturbance:
○ sedative/hypnotic drug withdrawal
○ meningitis, CVA
○ renal failure
○ fever (children)

recurrent seizures without a reversible
metabolic cause that may include repetitive
muscle jerking (convulsions):
○ genetic (autosomal dominant genes)
○ severe head injury
○ ischemic injury, tumour
○ Partial (focal):
- Simple - motor or sensory - remain conscious
- Complex - impairment of consciousness
○ Generalised:
- spreads to both hemispheres
- loss of consciousness
- > 30 min (may be life threatening)
 Goal:
 no seizures
 ↓ drug side effects
 60-80% patients obtain good seizure control

ACTIONS OF ANTISEIZURE DRUGS:
 Suppress discharge of neurons in seizure (suppress
propagation of seizure activity)
 Mechanisms of action:
○ block voltage-gated Na+ channels from return to activated state (↓
rapid repetitive neuronal firing)
○ block T-type Ca2+ channels that control oscillatory responses in
thalamic neurons
○ enhance the effect of inhibitory neurotransmitter GABA (open Cl-
channels)

USE OF ANTISEIZURE DRUGS:
 Drowsiness
 Confusion
 Ataxia (loss of coordinate muscular movement)
 Diplopia (double vision)

Speckmann Physiologie

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