The Neurological System Drugs for Seizures

CNS is surrounded and protected by….

the meninges. There is not a lot of space within the CNS for anything else.

There is not a lot of space within the CNS for anything else….

Bleeding due to injury or damage to an intercranial/intervertebral blood vessel

Inflammation which may be due to a disease process but is
usually related to an infection

Tumors or other lesions/cysts; may be benign or malignant

A seizure is a…

disturbance of electrical activity in the brain that can affect LOC, motor activity, and sensation;

someone having a seizure may experience all three, others may not. A seizure is a single occurrence.

Epilepsy is defined as…

Epilepsy is defined as two or more recurring
seizures.

Convulsions are defined as the…

Convulsions are defined as the involuntary spasmodic motor activity that occurs with some (but by no means all) seizures.

A seizure may be caused by an…

A seizure may be caused by an underlying disorder but over 50%
of seizures are idiopathic. In these cases, factors that affect the
seizure threshold are important.

Known causes of seizures include:

Known causes of seizures include:
• Fever; febrile seizure
• Infection
• Metabolic disorders; fluid/electrolyte
disturbances, hypoglycemia
• Cancer; a primary brain tumor or
metastatic disease
• Trauma/Toxin Exposure
• Vascular disease; respiratory hypoxia,
stroke, shock

There are three (3) classifications
of seizures:

•Partial • Generalized •Special types

Epilepsy is more common in…

children and young adults+ in people who are Hispanic and
there may also be a hereditary component.

Neurotransmitters related with seizures

*Gamma-aminobutyric acid (GABA)

*Glutamate/Aspartate

Anti-epileptic drugs (AEDs) work through the following
mechanisms:

1. Increase the activity of GABA through chloride ions
2. Inhibit the amount of sodium entering neurons
3. Inhibit the amount of calcium entering neurons
4. Correcting an imbalance of neurotransmitters
5. Blocking glutamate receptors (glutamate is an excitatory stimulant in the brain)

Drugs that activate or agonize GABA

1. Benzodiazepines: diazepam, lorazepam
2. Barbiturates: phenobarbital
3. gabapentin (Neurontin)
4. pregabalin (Lyrica)
5. topiramate (Topamax)

Benzodiazepines Side Effects

drowsiness, sedation, ataxia (CNS depression)

Barbiturates Side Effects

somnolence, dizziness, confusion (CNS depression, Stevens-Johnson Syndrome (SJS), agranulocytosis

Dilantin (phenytoin) Side Effects

somnolence, dizziness, nystagmus, gingival hyperplasia (agranulocytosis, SJS)

Phenytoin-like Side Effects

dizziness, ataxia, headache, visual disturbances, GI upset (agranulocytosis, SJS, liver failure, pancreatitis, heart block, suicidal behavior)