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Anticonvulsant Drugs Notes

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Lecture 28 Anticonvulsant drugs

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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