Seizure: is a paroxysmal event due to abnormal , excessive, discharges from CNS neurons i.e., from a shift in the normal balance of excitation and inhibition within the CNS. Epilepsy: is a chronic clinical phenomenon in which a person has recurrent seizures; accordingly a person with single seizure, or recurrent seizures due to corrable or avoidable causes, does not necessarily have epilepsy. Classification of seizure types: ط ق ف م ه ف راءه و قPartial seizures (consciousness preserved): Partial seizures involve only a portion of the brain, typically part of one lobe of one hemisphere. -Simple partial seizures: (consciouness normal); The patient often exhibits abnormal activity of a single limb or muscle group that is controlled by the region of the brain experiencing the disturbance. -Complex partial seizures: (consciousness altered/ no memory); These seizures exhibit complex sensory hallucinations and mental distortion. Motor dysfunction may involve chewing movements, diarrhea, and/or urination. Generalized seizures (consciousness lost/no memory): Generalized seizures may begin locally and then progress to include abnormal electrical discharges throughout both hemispheres of the brain.
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Web viewClonazepam, Diazepam and lorazepam are most often used as an adjunctive. therapy for for partial and generalized tonic-clonic seizures. 11- phenobarbitone:
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Seizure: is a paroxysmal event due to abnormal , excessive, discharges from CNS neurons i.e., from a shift in
the normal balance of excitation and inhibition within the CNS.
Epilepsy: is a chronic clinical phenomenon in which a person has recurrent seizures; accordingly a person
with single seizure, or recurrent seizures due to corrable or avoidable causes, does not necessarily have
epilepsy.
Classification of seizure types: فقط فهم و قراءه
Partial seizures (consciousness preserved): Partial seizures involve only a portion of the brain, typically
part of one lobe of one hemisphere.
-Simple partial seizures: (consciouness normal); The patient often exhibits abnormal activity of a single limb
or muscle group that is controlled by the region of the brain experiencing the disturbance.
-Complex partial seizures: (consciousness altered/ no memory); These seizures exhibit complex sensory
hallucinations and mental distortion. Motor dysfunction may involve chewing movements, diarrhea, and/or
urination.
Generalized seizures (consciousness lost/no memory): Generalized seizures may begin locally and then
progress to include abnormal electrical discharges throughout both hemispheres of the brain.
-Generalized tonic-clonic (grand mal) seizures: These seizures result in loss of consciousness, followed
by tonic (continuous contraction) and clonic (rapid contraction and relaxation) phases. The seizure may be
followed by a period of confusion and exhaustion due to the depletion of glucose and energy stores.
-Absence (petit mal) seizures: These seizures involve a brief, abrupt, and self-limiting loss of consciousness.
The onset generally occurs in patients at 3 to 5 years of age and lasts until puberty or beyond. The patient
stares and exhibits rapid eye-blinking, which lasts for 3 to 5 seconds.
- Febrile seizures: Young children may develop seizures with illness accompanied by high fever. Febrile
seizures consist of generalized tonic-clonic convulsions of short duration and do not necessarily lead to a
diagnosis of epilepsy.
-Status epilepticus: In status epilepticus, two or more seizures occur without recovery of full consciousness
between them. These may be partial or generalized (which is very dangerous and may cause brain death).
Mechanism of action of antiepileptic drugs:
The antiepileptic drugs appear to block the initiation or spread of seizures via one or more of 3 ways:
1-Control of neuronal membrane action potential:
A- Na+ channels blockade thereby inhibiting the generation of repetitive action potentials in the epileptic
focus and preventing their spread.: Phenytoin, Carbamazepine, Valproic acid, Lamotrigine, Topiramate.