Antiseizure Drugs

• Epilepsy is the sudden, excessive, and synchronous discharge of cerebral neurons
• Primary seizure has no specific anatomical cause for the seizure; manifests as trauma or neoplasm
• Secondary seizure is precipitated by several reversible disturbances such as tumors, head injury, meningeal infection, rapid withdrawal from alcohol
• Genetic Epilepsy is an inherited abnormality in the CNS and involves some genetic mutations
• Structural/Metabolic Epilepsy causes illicit drug use and if cause can be determined or corrected then medication is not necessary
• Focal seizures involves only a portion of the brain, typically part of one of one hemisphere
• Focal seizures may progress to become generalized tonic-clonic seizures
• Simple Partial seizures are caused by a group of hyperactive neurons exhibiting abnormal electrical activity and are confined in a specific area of the brain
• In simple partial seizures, patient does not lose consciousness or awareness and may show sensory distortions
• Complex Partial seizures cause complex sensory hallucinations, mental distortion, and altered consciousness
• In complex partial seizures, motor dysfunction may involve chewing movements, diarrhea, and/or urination
• Generalized seizures may begin locally and then progress to include abnormal discharges throughout both hemispheres of the brain
• Generalized seizures may be convulsive/non-convulsive and usually causes immediate loss of consciousness
• Tonic-Clonic is the most dramatic form of seizure
• Tonic-Clonic is also called Grand Mal
• Tonic-Clonic result in loss of consciousness, followed by tonic (continuous contraction) and clonic (rapid contraction and relaxation), followed by a period of confusion and exhaustion due to depletion of glucose and energy stores
• Absence Seizure is the brief, abrupt, and self-limiting loss of consciousness
• Absence Seizure is also called Petit Mal
• In absence seizure, patient stares and exhibits rapid eye-blinking which lasts for 3-5 seconds
• Myoclonic seizures causes short episodes of muscle contractions that may recur for several minutes which exhibit as brief jerks of the limbs
• Febrile seizures are generalized tonic-clonic convulsions of short duration with accompanying high fever
• Status Epilepticus seizures are rapidly current, and lasts longer than 5 minutes without returning to a normal level of consciousness
• Benzodiazepines are reserved for emergency or acute seizure treatment due to tolerance
• Clonazepam and Clobazam are adjunctive therapy for particular types of seizures
• Diazepam is used to or interrupt prolonged generalized tonic-clonic seizures or clusters when oral administration is not possible
• Carbamazepine is effective for treatment of focal and tonic-clonic seizures, trigeminal neuralgia and bipolar disorder
• Carbamazepine is effective for treatment of focal and tonic-clonic seizures, trigeminal neuralgia and bipolar disorder
• Carbamezapine is not for absence seizure as it may cause an increase in seizures
• Carbamazepine causes side effects like hyponatremia, blurred vision, Steven- Johnson syndrome and blood dyscrasias
• Eslicarbazepine is for partial onset seizures in adults
• Eslicarbazepine causes side effects like dizziness, somnolence, diplopia, and headache; serious ones include rash, psychiatric side effects and hyponatremia
• Eslicarbazepine causes side effects like dizziness, somnolence, diplopia, and headache; serious ones include rash, psychiatric side effects and hyponatremia
• Ethosuximide is for absence seizures
• Ethosuximide causes side effects like hyperactivity, sedation, GI upset, weight gain, lethargy, SLE, rash, blood dyscrasias
• Ezogabine is for control of partial onset seizures in adults
• Ezogabine causes urinary retention, QT interval prolongation, blue skin discoloration and retinal abnormalities
• Felbamate is for refractory epilepsies (Lennox-Gastaut syndrome) because of the risk of aplastic anemia
• Felbamate causes insomnia, weight gain, irritability, aplastic anemia, and hepatic failure
• Gabapentin is the adjunct therapy for focal seizures and for postherpic neuralgia
• Garbapentin is a good choice for elderly with partial seizures