EPILEPSY Tobias Milz SEIZURES synchronous high frequency discharge

EPILEPSY Tobias Milz

SEIZURES � synchronous, high frequency discharge of neurons from cortical or subcortical centres sudden change in behavior characterized by changes in sensory perception or motor activity

Non-epileptic seizures � result of extreme metabolic disturbance: ○ sedative/hypnotic drug withdrawal ○ meningitis, CVA ○ renal failure ○ fever (children)

Epileptic seizures EPILEPSY � recurrent seizures without a reversible metabolic cause that may include repetitive muscle jerking (convulsions): ○ genetic (autosomal dominant genes) ○ severe head injury ○ ischemic injury, tumour

EPILEPSY - Types ○ 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)

THERAPY �Goal: �no seizures �↓ drug side effects � 60 -80% patients obtain good seizure control

THERAPY � 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 Ca 2+ channels that control oscillatory responses in thalamic neurons ○ enhance the effect of inhibitory neurotransmitter GABA (open Cl- channels)

THERAPY – Side Effects � USE OF ANTISEIZURE DRUGS: �Drowsiness �Confusion �Ataxia (loss of coordinate muscular movement) �Diplopia (double vision)

Sources � Speckmann Physiologie � www. wikipedia. de/com � www. answers. com � www. dict. cc

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