Anticonvulsant Drugs Notes

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Lecture 28 Anticonvulsant drugs

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What is epilepsy?
o Definition
? Group of disorders all of which exhibit episodic seizures
? Paroxysmal dysfunction of brain neurophysiology (as seen on EEG)
? Accompanied by paroxysmal dysfunction of brain action (cognitive, behavioural, sensory, experiential)
? Has a tendency to recur NB: Not to be confused with febrile convulsions (hyperthermia) in children o Major causes
? Happen at young age

* Birth & perinatal injuries; congenital malformations

* Genetic (ion channels)

* Idiopathic
? Can happen at any time

* Vascular insults; head trauma

* Severe metabolic disturbances

* Drug/alcohol abuse

* Neoplasia

* Infection
? Epilepsy from some kind of damage

* EPILEPTIC focus- can be observed for some epilepsies that result from physical injury o Some have seizure in one place=localised legion o Some have seizure that start in one place and moves=generalised (secondary) o Intermittent and precipitated by
? Altered blood glucose and pH
? Stress; fatigue
? Flashing lights and noise
? No apparent cause Neurones exhibit PAROXYSMAL DEPOLARISING SHIFT (PAD) in epilepsy o Intracellular and extracellular events of PAD underlying the interictal epileptiform spoke detected by surface EEG o Theories of cause
? Pre-synaptically driven

* Presynaptic endings damaged and release lots of glutamate
? Synaptic

* Nerves releasing normal amount of glutamate but post synaptic cell=hypersensitive
? Post-synaptic

* Crumbly membrane and lets out + ions easily Types of seizure o Simple= no loss of consciousness o Complex= impairment of consciousness o Partial (localised) seizures
? Most difficult to treat with drugs

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