For seizure

● Entire brain is involved
● motor manifestations are bilateral.
● diffuse, affecting both cerebral hemispheres.
● clinical and EEG changes indicate initial involvement of both
hemispheres.

● Common in children
○ They experience brief loss of consciousness to the point that
they are staring blankly as well
● present as alterations of consciousness (absences) lasting
10-30 seconds.

● It can happen for more than 100 times per day
● Staring (with occasional eye blinking) and loss or reduction in
postural tone is typical.

Doc for ABSENCE (Petit mal) SEIZURES

● (bilateral massive epileptic myoclonus)
● present as involuntary jerking of the facial, limb, or trunk
muscles, possibly in rhythmic manner.

consist of sporadic jerks, usually on both sides of the body.
Patients sometimes describe the jerks as brief electrical shocks.
When violent, these seizures may result in dropping or
involuntarily throwing objects.

● characterized by sustained muscle contractions alternating
with relaxation
● are repetitive, rhythmic jerks that involve both sides of the
body at the same time.
○ Continuous jerking movement throughout the seizure
process

● involve sustained tonic muscle extension (muscle stiffening).
○ Muscle stiffness particularly in arms / legs (usually their arms
and legs are extended)

● cause sudden loss of consciousness.
● Combination of Tonic and Clonic seizure
○ Muscle stiffness (Tonic) + Jerking movements (Clonic)

● characterized by a sudden loss of postural tone so that the
individual falls to the ground. They occur primarily in children.
○ It’s like having Spastic Paralysis because there in no muscle
tone at all

● Some epileptics have serial grand mal seizures, regaining
consciousness briefly between attacks. In some cases, grand
mal seizures occur repeatedly with no recovery of
consciousness between attacks (status epilepticus)

● have no identifiable cause.

● occur secondary to an identifiable cause

one drug is used for the maintenance of certain conditions

● valproic acid, carbamazepine, phenytoin

GTC and PARTIAL SEIZURES

ethosuximide, valproic acid

ABSENCE

clonazepam, valproic acid

MYOCLONIC

diazepam, lorazepam, phenytoin

STATUS EPILEPTICUS

FEBRILE SEIZURES

Lamotrigene, VPA, Topiramide

TONIC CLONIC

○ Inhibition of voltage-gated Na+ channels to slow neuron firing.
○ Enhancement of the inhibitory effects of the neurotransmitter GABA.
○ Inhibition of calcium channels

blocks voltage-gated sodium channels by selectively binding
to the channel in the inactive state and slowing its rate of
recovery (Sodium channel blockers)

● MOA: closes Na channels
● Oldest non-sedative antiepileptic drug
● Elimination rate constant: From First Order it becomes Zero
Order at higher therapeutic level

– loss of muscle control

– vision condition that causes repetitive
uncontrolled movement

– double vision (Banlag)

– hypertrichosis – unwanted hair growth

(20-40%) – overgrowth gums

– cleft palate, congenital heart disease, microcephaly, growth and
mental retardation

Phenytoin is an