Anti-epileptic drug
What is epilepsy?
Types of epilepsy
classification of anti epileptic drug
RAJSHREE BHAWAR
ATAL BIHARI VAJPAYEE GOVERNMENT MEDICAL COLLEGE
What is epilepsy?
A disorder in which nerve cell activity in the brain is disturbed, causing seizures.
These are a group of disorders of the C N S characterised by
Epilepsy may occur as a result of a genetic disorder or an acquired brain injury, such as a
paroxysmal
trauma or stroke. cerebral dysrhythmia, manifesting as brief episodes
(seizures)
During a seizure, aof loss experiences
person or disturbanceabnormalofbehavior,
consciousness,
involuntarywith or of limbs
movement
without characteristic
and sensations, bodylossmovements
sometimes including (convulsions),
of consciousness. sensory between
There are few symptoms or
psychiatric phenomena. These episodes are unpredictable and
seizures.
their frequency is highly variable. Epilepsy has a focal origin in
the brain, manifestations depend on the site of the focus,
regions into which the discharges spread and postictal
depression of these regions.
Types of seizures
Generalised seizures
Partial seizures
Generalised seizure
They have a diffuse origin involving both hemispheres of
the brain; manifestations and EEG abnormalities arc
bilateral.
Generalised tonic-clonic seizures
Absence seizures
Atonic seizures
Myoclonic seizures
Infantile spasms (Hypsarrhythmia)
Partial seizures
They have a unilateral localised origin in the brain, but may
spread to small or large area, or to the whole brain. Focal origin
may be evident clinically, or may be detected in the EEG.
Simple partial seizures
Complex partial seizures
Simple partial or complex partial
seizures second- arily generalized
Generalised tonic-clonic seizures
(GTCS, major epilepsy, grand mal): lasts 1-2 min.
The usual sequence is : aura
⬇️
cry
⬇️
unconsciousness and patient falls
⬇️
tonic spasm of all body muscles-clonic jerking
⬇️
prolonged sleep and depression of all CNS functions
Absence seizures
(minor epilepy, petit mal): prevalent in children. lasts about 1/2 min
No or only momentary loss of consciousness,
No fall,
Patient apparently freezes and stares in one direction.
No muscular component or minimal bilateral jerking or blinking of eyes,
EEG shows characteristic 3 cycles per second spike and wave
pattern.
Episodes may occur each day.
Seizures may remit spontaneously in adolescence.
Atonic seizures
(Akinetic epilepsy)
Brief loss of consciousness with relaxation of all
muscles due to excessive inhibitory discharges.
Patient may fall.
Myoclonic seizures
Shock- like momentary contraction of muscles of a limb
or the whole body. Myoclonic jerking may accompany
any type of generalised or partial seizures.
Infantile spasms (Hypsarrhythmia)
Seen in infants. Probably not a form of epilepsy.
Intermittent muscle spasm and progressive mental
deterioration. Diffuse changes in the interseizure EEG
are noted.
Simple partial seizures
(SPS)
sudden onset unilateral clonic jerking of a group of muscles or a limb
lasting 30-90 sec
localised sensory diturbances such as pin pricks. visual/auditory
hallucinations, etc.
The patient remains conscious and aware of the attack.
Complex partial seizures
(CPS, temporal lobe epilepsy. psychomotor)
attacks of bizarre and confused behaviour
dream- like state and purposeless movements
walking unaware
emotional changes lasting 1-2 min along with impairment of
consciousness
The patient has no recollection or the attack
An aura often precedes
The seizure focus is located in the temporal lobe
Simple partial or complex partial
seizures secondarily generalised
The partial seizures occurs first and evolves into generalised tonic-
clonic seizures with loss of consciousness.
Most of the cases of epilepsy are primary
( idiopathic), some may be secondary to trauma/
surgery on the head , intracranial tumour,
tuberculoma, cysticercosis, cerebral ischaemia, etc.
Treatment is symptomatic, depends mostly on the
seizure type, but not on the etiology of seizure or
whether it is primary or secondary.
Classification of anti-epileptic drugs
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