Challenge 2010

propound

Lecture Notes

Lecture Title : Epilepsy Prof name : Dr.Mostafa Shihebat Done by : Pharmacy students Corrected by : Dentistry students

Epilepsy

Page 1

Epilepsy
First we must differentiate between epilepsy and seizure: Seizure )‫ :( النوبة‬it is a pretemporary disturbance in the electrical activity and excessive neuronal discharge and it is the symptom of epilepsy disorder .

‫( زٌادة فً الشحنات الكهربٌة فً الدماغ او منطقة معٌنة منه , او زٌادة نشاط‬ )‫الخالٌاة العصبٌة أو مجموعة منها‬
Epilepsy )‫ : (الصرع‬it is a chronic neurologic disorder, characterized by a seizures . Remind that neurotransmitters are: 1-exitotary, for example : glutamate and aspartate 2-inhibitory, for example : GABA (ɣ-aminobutyric acid) ɣ=gama

-

when there is an excessive secretion of excitatory neurotransmitters or imbalance between excitatory and inhibitory neurotransmitters , this will lead to epilepsy , so we can say that the cause is some neuronal cells fire abnormally.

Epilepsy

Page 2

- if a person has one seizure , can we say that he has epilepsy
? No, because ti one time seizure, if he stay for 2-3 years without recurrent of other once , he is not an epileptic patient , so the seizure must recurrent to consider epilepsy .

- 90% of epilepsy occurs in developing countries, and the average age of epileptic patient is 25 yr. old, however, any age can get epilepsy any time . There are many people with epilepsy who are within the age 6 to 10 years. So there is no limited age for epilepsy, it could happen to old or young people.(50% epilepsy happens at the age of 25) The brain is the source of epilepsy , all brain functions like moving muscles ,thinking, seeing, feeling and others are depend on electrical signals that pass between neurons in the brain . Seizures occur when too many nerves in the brain fire too quickly causing an electrical store.

-

causes of epilepsy: 1) 70% of epileptic people with unknown . 2) 30% have known causes: 1. trauma in the head )‫( صدمة أو رضة‬

Epilepsy

Page 3

2. Infections in brain like meningitis. 3. Heredity, genetic mutation. Let us talk about genetic mutation: Some genetic mutations may occur in the genes that code for sodium channel proteins; these defective sodium channels stay open for too long, so more Na enter the post synaptic and Glutamate, an excitatory neurotransmitter, may, therefore, be released in large amount , so the excitation increased in the post synaptic neurons .

‫ٌعنً ان التغٌر الذ ي ٌحدث عادة ما ٌحدث فً الجٌن المسؤول عن صناعة‬ ‫البروتٌن المخصص لصنع قنوات الصودٌوم , فعندما ٌحدث الخلل , تبقى قنوات‬ ‫الصودٌوم مفتوحة , فٌزٌد افراز الخلٌة العصبٌة للصودٌوم وٌدخل للخلٌة‬ ‫العصبٌة المجاورة لها, وبذلك أٌضا ٌتم افراز الناقل العصبً المُنشط مثل‬ ‫الجلو تامٌت , وٌدخل الخلٌة المجاورة مما ٌجعلها فً حالة نشاط وتحفز لفترة‬ ‫أطول , وهذا ما ٌخلق سٌاالت عصبٌة وشحنات كهربٌة متسارعة وبشكل غٌر‬ . ‫الذي ٌألفه الدماغ‬
Seizures are classified into 2 types:

Generalized seizure

Partial ( or localized ) seizure

Epilepsy

Page 4

Involve all the brain and include loss of consciousness

The source of charges is only a part from the brain , it may include loss of consciousness or not ,usually it can be marked by jerking of eyes only

-

Very important note :

Source of seizures it may be any region in the brain , but some regions are more susceptible to cause seizures , the most important region is the Hippocampus which is responsible for short term memory , long term memory , spatial navigation.

The Hippocampus, which contains a large volume of just such glutamate ( excitatory neurotransmitter) , is especially vulnerable to epileptic seizure and subsequent spread of excitation , so it is considered as a major source of epilepsy .

okf

symptoms that indicate a seizure disorder :

Epilepsy

Page 5

1. 2. 3. 4. 5.

(it is vary from one to other ,depending on the seizure type ) The most important one is, the recurrence of seizure. Sudden falls for unknown reason. Confused memory, emotional disorders. Visual and hearing disorders . Convulsion or not ,( don’t forget that generalized epilepsy is always associated with convulsion) .

6. Lip smashing, chewing, repetitive and involuntary but coordinated movement, muscular contraction of the face. 7. Muscle rigidity, spasm, head turning, eye jerking (blinking). The duration of a seizure it may range from 1-2 minutes , it may happened only by jerking eyes , it depend on the seizures type and the region in the brain that considered the source of the electrical changes .

-

Treatment :

Epilepsy is not curable , treatment is for controlling only , that means , instead of having one episode ) ‫( نوبة‬every week , it will be every 3 years . -Epilepsy is not shameful. -It doesn’t effect the IQ of person , and doesn’t cause any mental retardation in general .
Epilepsy Page 6

- How to diagnosis epilepsy? 1) ECG , but it may appear normal in some epileptic patient 2) MRI (Magnetic resonance imaging) . 3) CG scan = computed tomography scan .

-

What to tell your doctor if you have epilepsy ?

Tell him about symptoms patterns , how you felt after the episode and preseizure activity.

-

What propagate epilepsy?

1) There is 2 important factors: flashing of lights, photosensitivity and Hyperventilation. 2) Stress and anxiety. 3) Hormonal changes. 4) Lack of sleep. 5) Menses (menstrual cycle ). 6) Mismedication.

-

Treatment may be by medications or by surgery which used to remove the hyper active region in the brain. How o help an epileptic patient? First and the most important thing is to keep the airways opened , and put something rubber to bite by his teeth in order not to bite his tongue or cut it and to avoid any
Page 7

Epilepsy

thing may stop his breathing . (shoes), as Doctor mentioned as an example for the previous case.

-

avoid any thing may harm him like knives , sharp things. In the hospital , they may give him( IV) Na- thiopental or pentothal which is short rapid acting Barbiturates . that are a class of drugs that act on the GABAA receptor in the CNS. We know that GABA have inhibitory action that antagonize )‫ ( لها عمل وتأثٌر مضاد‬the excitatory action , then it decrease and prevent the neuronal hyperactivity Barbiturates have anxiolytic )‫ ( مهدىء‬and anticonvulsant
) ‫. (مضاد للتشنجات‬ ) ‫) وهذا مناسب فً حالة النوبات الصرعٌة التً ترافقها التشنجات‬

-

-

GOOD LUCK

Epilepsy

Page 8

Sign up to vote on this title
UsefulNot useful