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Epilepsy

QuestionAnswer
Partial seizures begins in one side of hemisphere of brain; unilateral; assymetric movements; associated with aura
Generalized sizures begins in both hemispheres of brain, bilateral movements, no aura
Absence seizures blank stare, upward rotation of eyes, lip smacking, can be precipiated by hyperventilation
Absence DOC ethosuximide; if has absence and generalized tonic-clonic and >2 years, can give VPA
Tonic Phase rigid, violent, suddent muscular contractions, cry/moan deviation of eyes and head to one side; rotation of body and distortion of features, suppression of respiration, fall to ground, loss of consciousness, tongue biting, urination
Clonic Phase repetitive jerks, cyanosis, foaming of mouth, small grunts, deep respirations
DOC for tonic-clonic seizures phenytoin, CBZ, topiramate, VPA
drugs that cause epilepsy recreations, imipenam, lindane, lidocaine, metoclopramide, theophylline, TCAs, meperidine, CBZ, ethosuxamide, Phenytoin, phenobarbital
phenobarbital indication neonatal seizures; generalized (except absence
phenobarbital ADRS drowsiness, dizziness, light headedness, incoordination, HAs, nervousness, hyperactivity in children, low memory, low IQ, folate deficiency, vitamin K deficiency hemorrhage, hepatic failure, SJS, teratogenic
phenytoin indications all except absence and febrile seizures
phenytoin ADRs N/V, drowsiness, dizziness, peripheral neuropathy, hydantoin facies, acne, hirsituism, gingival hyperplasia, osteomalacia, Vit K deficiency, folate deficiency, hepatic failure, SJS, teratogenic
phenytoin reference range 10-20
CBZ reference range 4-12
CBZ indications most widely used in children; doc for complex partial seizures; good in generalized seizures except absence and febrile
CBZ BBW aplastic anemia
CBZ ADR rash, N/V, drowsiness, dizziness, neutropenia, SIADH, osteomalacia, folate deficiency, hepatotoxicity, aplastic anemia, teratogenic
VPA reference range 50-150
VPA indications all types generalized and partial, doc for absence; not used in children less than 2 years
VPA ADRs n/v, weight gain, alopecia, tremo, thrombocytopenia, elevation in LFTs, fatal hepatotoxicity, pancreatic hemorrhage, teratogenicity
VPA BBW hemorrhagic pancreatitis, fatal hepatotoxicity, teratogenicity
Felbamate Felbatol
Felbamate indications lennox gastaut, tonic clonic, tonic myoclonic, refractory partial seizures with or without generalization
Felbamate ADR weight loss, hepatotoxicity, aplastic anemia
Felbamate BBW aplastic anemia, hepatotoxicity
Gabapentin indicatons partial seizures; more for peripheral neuropathies
lamotrigine indications partial seizures, primary or secondary generalized tonic-clonic; absence, lennox gastaut
lamotrigine ADR BBW-skin rash
topiramate indications > 10 years, partial onset seizures, primary generalized tonic-clonic seizures (MONOTHERAPY); 2-16 years and adults-partial onset, primary generalized tonic-clonic (ADJUNCTIVE; >2 years, Lennox-Gastaut
Topiramate ADRs drowsiness, dizziness, difficulty concentration, loss of appetite, mood changes, paresthesias, metabolic acidosis, acute myopia and closed angle closure, kidney stones, paresthesias, word finding difficulties, significant weight loss, oligohidrosis
tiagibine gabitril
tiagiibe indication partial seizures
zonisamide zonegran
zonisamide indications partial seizures
zonisamide ADR kidney stones, weight loss, oligohydrosis, reversible or irreversible pyschosis
zonisamide BBW oligohydrosis
antiepileptics that cause kidney stones and oligohydrosis zonisamide and topiramate
Levetiracetam indication partial seizures
levetiracetam ADRs dizziness, drowsiness, sedation
status epilepticus seizure > 5 minutes or 2 or more discreet seizures where there is incomplete recovery of consciousness; it is medical emergency
status epileticus treatment 1) BZDs - ativan, valium, 2) IV phenytoin 3) IV phenobarbital 4) IV Midazolam 5) medically induced coma (pentobarbital)
other therapies for status epilepticus propofol, topiramate, magnesium, lidocaine, IVIg
febrile seizure treatment 1) rectal BZD with ativan or valium; 2) diastat - diazepam gel
Created by: cytoskeletor
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