Pharmacology
Antiepileptics
1. Epilepsy
Common disorder characterised by seizures: episodic neuronal discharges
0.5-1% of population affected
Often no recognisable cause
- Brain damage –trauma, stroke, infection, tumour
- Inherited neurological syndrome
Neurological disorders, exhibit periodic seizure
Seizures –episodic high-frequency discharge of impulses by a group of neurons (focus)
Can start as local discharge, may spread
Symptoms –depends on area of brain affected and it’s function, from brief lapse in attention to
convulsion that can cause the patient to stop breathing (motor cortex involved)
2. Imaging
Electroencephalography (EEG) (picture)
- Detects electrical activity
- Recordings made from electrodes
- Type of seizure recognised by nature &
distribution of the abnormal discharge
Magnetic resonance imaging (MRI): see if there’s
something in the brain that’s causing the seizures
Position emission tomography (PET): see if there’s
change in the metabolism in the brain
3. Types of epilepsy
Seizure classification
Partial: conscious/unconscious, can spread and become generalised
- Jacksonian epilepsy: can spread and involve all body within 2 mins and the slowly die out, can
cause loss of consciousness but not always
Focus in motor cortex – repetitive involuntary jerking of a muscle group, rubbing,
patting or even repetitive walking or dressing
Begins one side of body – thumb, big toe, angle of mouth – spreads
- Psychomotor epilepsy
Consists of purposed movements
Lasts a few mins
Patient recovers with no recollection
Generalised: unconscious, involves the whole brain including reticular system (consciousness)
- Tonic-clonic
Two phases
o Initial strong contraction of whole musculature – tonic phase
o Series of violent, synchronous jerks – clonic
Injury can occur during convulsions
- Absence seizure (more common in children)
Abruptly stops activity, stares vacantly for a few seconds
Recover abruptly with no aftereffects
- Lennox-Gastaut (generally in children)
Severe, associated with progressive mental retard
Due to excitotoxic neurodegeneration?
Antiepileptics
1. Epilepsy
Common disorder characterised by seizures: episodic neuronal discharges
0.5-1% of population affected
Often no recognisable cause
- Brain damage –trauma, stroke, infection, tumour
- Inherited neurological syndrome
Neurological disorders, exhibit periodic seizure
Seizures –episodic high-frequency discharge of impulses by a group of neurons (focus)
Can start as local discharge, may spread
Symptoms –depends on area of brain affected and it’s function, from brief lapse in attention to
convulsion that can cause the patient to stop breathing (motor cortex involved)
2. Imaging
Electroencephalography (EEG) (picture)
- Detects electrical activity
- Recordings made from electrodes
- Type of seizure recognised by nature &
distribution of the abnormal discharge
Magnetic resonance imaging (MRI): see if there’s
something in the brain that’s causing the seizures
Position emission tomography (PET): see if there’s
change in the metabolism in the brain
3. Types of epilepsy
Seizure classification
Partial: conscious/unconscious, can spread and become generalised
- Jacksonian epilepsy: can spread and involve all body within 2 mins and the slowly die out, can
cause loss of consciousness but not always
Focus in motor cortex – repetitive involuntary jerking of a muscle group, rubbing,
patting or even repetitive walking or dressing
Begins one side of body – thumb, big toe, angle of mouth – spreads
- Psychomotor epilepsy
Consists of purposed movements
Lasts a few mins
Patient recovers with no recollection
Generalised: unconscious, involves the whole brain including reticular system (consciousness)
- Tonic-clonic
Two phases
o Initial strong contraction of whole musculature – tonic phase
o Series of violent, synchronous jerks – clonic
Injury can occur during convulsions
- Absence seizure (more common in children)
Abruptly stops activity, stares vacantly for a few seconds
Recover abruptly with no aftereffects
- Lennox-Gastaut (generally in children)
Severe, associated with progressive mental retard
Due to excitotoxic neurodegeneration?
