Epilepsy: Definitions, Management, and Treatment

Comprehensive vocabulary flashcards covering the definitions, pharmacological treatments, syndromes, and clinical management of epilepsy based on the lecture notes.

Seizures

Any abnormal electrical firing of a neuron inside the brain due to the depolarization of the neuron.

Convulsions

A specific type of seizure where the abnormally firing neuron is a motor neuron, resulting in involuntary body movements.

Epilepsy

A chronic condition characterized by recurrent and paroxysmal (sudden, episodic) attacks of seizures that require medical treatment.

Status Epilepticus

Defined as an acute seizure lasting for more than $5\,minutes$, constituting a medical emergency.

Focal Epilepsy

Pathophysiology where the abnormal neuronal firing is localized to only one hemisphere of the brain, usually without loss of consciousness.

Generalized Epilepsy

Pathophysiology where the neurons of both hemispheres are actively firing, characterized by a loss of consciousness.

Absence Seizures

Also known as Petit mal epilepsy, characterized by no convulsions and an EEG showing a $3\,Hz$ wave spike pattern.

Lennox-Gastaut Syndrome

A syndrome occurring mainly in children with mental retardation, presenting with myoclonic, tonic, and atonic seizures.

Dravet's Syndrome

Defined as severe myoclonic epilepsy in infancy; treated with Valproate, Clobazam, and the orphan drug Stiripentol.

West syndrome

Also known as Infantile Spasm or Hypsarrhythmia; treated with ACTH or Vigabatrin if associated with Tuberous Sclerosis.

Vigabatrin

The Drug of Choice (DOC) for infantile spasms associated with Tuberous Sclerosis; can cause visual field contraction.

Janz syndrome

An alternative name for Juvenile Myoclonic Epilepsy.

Phenytoin and Carbamazepine Contraindication

These drugs are explicitly contraindicated in myoclonic epilepsy because they aggravate the condition.

Levetiracetam

The Drug of Choice (DOC) for epilepsy during pregnancy as it is the least teratogenic, though it is unsafe for breastfeeding.

Valproate Pregnancy Profile

The most teratogenic anti-epileptic drug but the least secreted into breast milk, making it safe for breastfeeding.

Lorazepam

The overall Drug of Choice (DOC) for Early Status Epilepticus, administered at $0.1\,mg/kg$ IV.

Fos-phenytoin

A prodrug of phenytoin that is more water-soluble and faster acting; preferred in emergencies like status epilepticus.

Seizure Cascade

Triggered when hyperpolarization fails and depolarization occurs via $Na^+$ and $Ca^{2+}$ entry, leading to the release of excitatory glutamate.

Phenytoin

A non-sedative sodium channel blocker with a therapeutic blood level of $10$ to $20\,mg/ml$ and zero-order metabolic kinetics at high doses.

Hydantoin syndrome

Teratogenic effect of phenytoin characterized by microcephaly, cleft lip and cleft palate, and hypoplastic phalanges.

Carbamazepine

The Drug of Choice (DOC) for Trigeminal Neuralgia and a treatment for bipolar disorder; acts as a CYP enzyme autoinducer.

SIADH (Syndrome of Inappropriate Antidiuretic Hormone)

A side effect of Carbamazepine that causes water retention and hyponatremia, especially in elderly patients.

HLA B*1502

The specific HLA type associated with a high risk of Stevens-Johnson Syndrome when taking Carbamazepine.

Lacosamide

A second-line drug for focal seizures that slows sodium channel inactivation and inhibits the release of CRMP-2.

Topiramate and Zonisamide

AEDs that block sodium channels and carbonic anhydrase; both are used as anti-obesity drugs but can cause kidney stones.

Ethosuximide

The preferred agent for absence seizures in children; acts exclusively by blocking T-type calcium channels.

Brivaracetam

An AED that inhibits $Na^+$ channels and is explicitly approved for focal seizures treatment.

SV2A (Synaptic Vesicle 2A)

The specific protein inhibited by Levetiracetam to prevent the release of glutamate.

Tiagabine

A GABA transporter inhibitor that prevents the reuptake of GABA back into the presynaptic terminal.

L-carnitine

The specific supplement used to treat hyperammonemic encephalopathy caused by high ammonia levels from Valproate.