Anticonvulsants Flashcards
(88 cards)
what are seizures:
sudden, transient episodes of brain dysfunction and altered behavior due to ABNORMALLY EXCESSIVE, SYNCHRONOUS, AND RHYTHMIC FIRING (electrical discharge) of certain populations of hyper-excitable neurons in the brain
What are convulsions?
Seizure when motor neurons are activated = involuntary contractions of skeletal muscle
Causes of seizures:
1) CNS injury - altered excitation thresholds of certain cerebral neurons - head trauma, stroke, tumors
2) Congenital abnormalities in brain -birth trauma
3) Genetic factors - defective genes coding for voltage-gated ion channels or GABA receptors
4) infections, hypoglycemia, hypoxia, toxic and metabolic disorders
what is epilepsy?
chronic neurological disorder characterized by recurrent seizures
primary epilepsy origin?
unknown
secondary epilepsy origin?
identifiable cause (trauma, tumor, infection, development anomalies)
Partial epileptic seizures - types:
- simple partial
- complex partial
- partial becoming generalized
Simple partial-
1) type of seizure?
2) spread?
3) consciousness?
4) motor/sensory manifestation?
1) Partial epileptic
2) least complicated; *Minimal spread of abnormal neuronal discharge
- USUALLY JUST ONE LIMB IS AFFECTED
3) NO LOSS OF CONSCIOUSNESS - person alert and can remember it
4) Limited motor/sensory manifestations
Complex partial-
1) type of seizure?
2) affects how and what parts of brain
3) consciousness?
4) behavior after?
1) Partial epileptic
2) **Starts in small brain area (one lobe) and quickly spreads to other areas ex) limbic system which effects alertness and awareness
3) ALTERED CONSCIOUSNESS with potential automatisms (lip smacking, fumbling, swallowing)
4) Strong emotional feelings, gradual recovery of consciousness after 30-120sec
Partial becoming generalized seizures:
1) type of seizure:
2) where/how affect brain?
1) Partial epileptic
* *2) partial that spreads throughout brain and progresses to a generalized seizure –> TONIC CLONIC
Generalized seizures types:
1) absence (PETIT MAL)
2) tonic-clonic (Grand mal)
3) tonic
4) atonic
5) clonc and myoclonic
6) infantile spasms
7) status epilepticus
Absence (Petit Mal) seizure:
1) type?
2) start and stop?
3) consciousness?
4) who gets?
5) how get?
1) generalized seizure - Entire brain - bilateral brain effects
2) Sudden start and stop 10-45 seconds
3) **BRIEF LOSS OF CONSCIOUSNESS - ranges from no motor signs to symmetrical jerking or movement of eyelids, extremities or entire body
4) CHILDREN GET THIS <15yo - May dev into tonic-clonic
5) Inducible by hyperventilation, stress or flashing lights
Tonic clonic seizures:
1) type?
2) what affected?
3) consciousness?
4) phases?
1) generalized seizure
2) Tonic spasms and major convulsions of entire body (bilateral)
3) LOSS OF CONSCIOUSNESS - Profound CNS depression after
5) a) Aura=patients sense seizure coming on
b) Tonic=muscle tensing and rigidity of all extremities – then tremors
c) clonic=convulsions due to rapid and repeating muscle contractions and relaxing –> uncontrolled shaking of the body
d) stupor and sleep
Tonic
1) type?
2) consciousness? effects on person/brain?
1) generalized seizure
2) Loss of consciousness with severe hypertonic spasms and autonomic effects
Atonic
1) type?
2) effects on person?
3) who gets often?
1) generalized seizure
2) **sudden loss of postural tone **resulting in falls or dropping of head and torso if in sitting postion
3) children
Clonic and myoclonic
1) type?
2) consciousness? Effect on person?
1) generalized seizure
2) loss of consciousness with rhythmic clonic contractions phase and time matched to EEG pattern
infantile spasms
1) type?
2) what happens?
1) generalized - epileptic syndrome and not a seizure type
2) recurrent myoclonic jerks of the body with sudden flexion or extension of the body and limbs
- *status epilepticus
1) type?
2) what happens?
1) generalized seizure
* *2) continuous or very rapid recurring seizures - tonic clonic type
**MEDICAL EMERGENCY
3 stages of mechanism to epileptic seizure
DONT WORRY ABOUT THIS
1) initiation
a) abnormal function of Ca ion channels - increased generation of AP
2) Synchronization of surrounding
a) decreased inhibition of GABA - GABA INHIBITS so less inhibition
b) other areas start getting funky
3) propagation –> recruitment of normal neurons
Goal of antiepileptic meds?
restore normal patters of electrical activity - prevent CNS damage by uncontrolled reoccurence
so we inhibit seizures but cant cure seizures
Antiepileptic meds eliminate seizures in what % of patients?
What % do not respond to these meds?
2/3
20% no response
Epileptic treatment options:
1) meds
2) surgery - temporal lobe related seizures
3) vagus nerve stimulation (VNS) - drug resistant patient with partial seizures
Cyclic Ureides list drugs:
Phenytoin Forphenytoin Primidone phenobarbital ethosuximide
Tricylcic list drugs:
carbamazepine
oxcarbazepine
