Tobias Milz
synchronous, high frequency discharge of neurons from cortical or subcortical centres sudden change in behavior characterized by changes in sensory perception or motor activity
result of extreme metabolic disturbance : ○ sedative/hypnotic drug withdrawal ○ meningitis, CVA ○ renal failure ○ fever (children)
recurrent seizures without a reversible metabolic cause that may include repetitive muscle jerking (convulsions): ○ genetic (autosomal dominant genes) ○ severe head injury ○ ischemic injury, tumour
○ 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)
Goal: no seizures ↓ drug side effects 60-80% patients obtain good seizure control
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 Ca2+ channels that control oscillatory responses in thalamic neurons ○ enhance the effect of inhibitory neurotransmitter GABA (open Cl- channels)
USE OF ANTISEIZURE DRUGS: Drowsiness Confusion Ataxia (loss of coordinate muscular movement) Diplopia (double vision)
Speckmann Physiologie