Drug of choice for various types of seizures - Pharmacology : Dr Rajesh Gubba

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Seizures may be partial (affects one area of the brain) or generalized (diffuse)

However, partial seizures may progress to be generalized
Epilepsy: used to describe condition of recurrent seizures
Causes for epilepsy: genetic, infection, trauma, stroke, metabolic (hypo or hypernatremia)

Simple partial seizures
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Patient remains conscious
Can manifest as motor, sensory, psychic, or autonomic changes
Treatment: all anti-seizure drugs work effectively

Complex partial seizures
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Patient has impaired consciousness
Treatment: all anti-seizure drugs work effectively
Absence (Petit Mal) seizures
Usually in children, manifest as a blank stare
Treatment: First line anti-seizures drug treatment is ethosuximide.
Valproic acid is used as a second line agent

Myoclonic seizures
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Repetitive jerks of the body or extremities
Treatment: First line agent is valproic acid.
Tonic-Clonic (Grand Mal) seizures
Patient is tonic (stiff) and then becomes clonic (jerking movements)
The 3 first line anti-epileptics for tonic-clonic seizures have a similar mechanism (↑ Na channel inactivation) and can be remembered by “PVC”:
Phenytoin (also first line for prophylaxis of status epilepticus)
Valproic acid (also used for myoclonic seizures)
Carbamazepine (also first line for trigeminal neuralgia)

Status epilepticus
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Life threatening, persistent seizure activity in the brain
Treatment: First line anti-seizure drugs are benzodiazepines, such as diazepam. First line drug for prophylaxis is phenytoin to increase seizure threshold

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