Pathogenesis - usually idiopathic - other causes

Generalized seizures - tonic-clonic (grand mal) - myoclonic - tonic - atonic - absence (petit mal) - infantile - atypical absence spasms Classification of seizures

Differential diagnosis: -Syncope -Vertigo -Tics -Psychogenic symptoms -Breath holding spells -Reflux in infants

Plan/Management -Status epilepticus requires transport to ED -Refer to neurologist for accurate classification of seizure type -Monotherapy over polytherapy -Monitor CBC, LFTs, drug levels -Treatment for 2 years (seizure free)

 Partial seizures Oxcarbazepine Carbamazepine Phenytoin Phenobarbital Levetiracetam Lamotrigine Topiramate  Absence seizures Ethosuximide Valproic acid

 Tonic-Clinic Seizures Phenytoin Valproic acid Carbamazepine Topiramate Levetiracetam  Myoclonic and Atonic Seizures Clonazepam Lamotrigine - Levetiracetam Infantile Spasms - ACTH - Topamax

 Used for seizures longer than 5 minutes in length or for clusters of seizures

Goal of pharmacologic treatment: seizure control without adverse effects