Antiepileptics

Epilepsy
A group of chronic CNS disorders characterized
by recurrent seizures.

• Seizures are sudden, transitory, and uncontrolled

episodes of brain dysfunction resulting from
abnormal discharge of neuronal cells with
associated motor, sensory or behavioral changes.
Main figures and characteristics

https://youtu.be/6NcqQkKjqTI
 FACTS
 There are 2.5 million Americans with epilepsy in the US alone.
 More than 40 forms of epilepsy have been identified.
 Therapy is symptomatic in that the majority of drugs prevent
seizures, but neither effective prophylaxis or cure is available.
 One person in 20 will have an epileptic seizure at some time in their
life.
 Epilepsy is diagnosed on the basis of two or more epileptic
seizures.
 Around 450,000 people in the UK have epilepsy (40 million people
worldwide).
 Approximately 1% of the world’s population has epilepsy.
 Second most common neurologic disorder after stroke.
Epilepsy is usually controlled, but cannot be cured with
medication, although surgery may be considered in difficult
cases.
However, over 30% of people with epilepsy do not have
seizure control even with the best available medications.
Not all epilepsy syndromes are lifelong –some forms are
confined to particular stages of childhood.
Epilepsy should not be understood as a single disorder, but
rather as syndromic with vastly divergent symptoms but all
involving episodic abnormal electrical activity in the brain.
•Underlying causes of seizure should be identified and
treated before starting with anti-seizure drugs.
 Convulsions

 A convulsion is a medical condition where body muscles

contract and relax rapidly and repeatedly, resulting in an
uncontrolled shaking of the body.
 Because a convulsion is often a symptom of an epileptic
seizure, the term convulsion is sometimes used as a
synonym for seizure.
 However, not all epileptic seizures lead to convulsions,
and not all convulsions are caused by epileptic seizures.
 Convulsions are also consistent with an electric shock.
Age related incidence of seizures
 Causes for Acute Seizures

 Trauma  Tumor
 Encephalitis  High fever
 Drugs  Hypoglycemia
 Birth trauma  Extreme acidosis
 Withdrawal from  Extreme alkalosis
depressants  Hyponatremia
 Hypocalcemia
 Idiopathic
MAIN DRUGS FOR TREATMENT
Mechanisms of actions

https://youtu.be/GMyCWup1Xqo
 Febrile Seizure
Febrile seizures are the most common
seizure disorder in childhood, affecting 2 -
5% of children between the ages of 6
months and 5 years

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 Febrile Seizure6
 Caused by the increase in the core body
temperature greater than 100.4o F or 38o C

 Threshold of temperature which may

trigger seizures is unique to each individual

 Can occur within the first 24 hours of an illness

 Can be the first sign of illness in 25 - 50% of patients

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Febrile Seizure: Characteristics

 Are benign

 Occurrence: between 6 months to 5 years of age

 May be either simple or complex type seizure

 Seizure accompanied by fever (before, during or after)

WITHOUT ANY
 Central nervous system infection
 Metabolic disturbance
 History of previous seizure disorder

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Febrile Seizure: Two Types
Simple Febrile
 6 months – 5 years of age
 Febrile before, during or after
seizure
 Includes all of the following
 Seizure lasting less than 15
minutes
 Generalized seizure
 Occurs once in a 24-hour
period
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Complex Febrile
 6 months – 5 years of age
 Febrile before, during or after
seizure
 One or more of the following
 Prolonged (lasting more than
15 minutes)
 Focal seizure
 Occurs more than once in 24
hours