Health is Wealth

SEIZURE

Caused by transient, paroxymal and synchronous discharge

of groups of Neurons in the brain


Clinical manifestations depends on the location and number

of neurons involved, in the seizure discharge and its duration.

May be

1.Transient or

2.Permanent (Epilepsy)

Classification of Epileptic seizures

• Partial

• Generalized

• Unclassified

PARTIAL

-Simple partial seizures (consciousness not impaired)

- Complex partial seizures (consciousness impaired)

- Partial seizures evolving to generalized seizures (Tonic, clonic or tonic-clonic)


GENERALIZED SEIZURES
(Convulsive or non convulsive)

•Absence seizures

•Myoclonic seizures

•Clonic seizures

•Tonic seizures

•Clonic tonic seizures

•Atomic seizures.


DRUGS USED IN DIFFERENT DISORDERS

Partial Seizures

- Carbamazepine

- Phenyotin and

- valproate

Generalized seizures

- Carbamazepine

- Phenyotin
- Valproate

- Barbiturates

- Gabapentin or

- Lamotrigine

Generalized non seizures

- Ethosuximide (or)

- Valproate

SIDE EFFECTS

Depression of cerebral function with symptoms of sedation

- Diploma

- Persistent or fluctuation ataxia

Dyskinesias of the tongue, face and limbs

- Mild sensory neuropathy

- Altered peripheral nerve function

•Hepatic failure

• Pancreatitis

• Mild anaemia to aplastic anaemia

• Depress circulating platelets

• Skin rashes

• SLE

• Seroderma and

• Sjogrens syndrome

• Steven johnsons syndrome

STATUS EPILEPTICUS

Def : Continuous seizure activity or two or more seizures

occurring in sequence without recovery of consciousness between the seizures

PHARMACOLOGIC MANAGEMENT OF STATUS EPILEPTICUS

1.Lorazepam / Diazepam – 0.1 mg / kg I.V at 2 mg/ min

2.Phenytoin – 20mg / kg I.V at 50mg / min or fosphenytoin 20mg/kg IV at 150mg/min

3.Phenyotin or fosphenytoin additional 5-10 mg/kg

4.Phenobarbitol 20mg/kg I.V at 50-75 mg/min

5.Phenobarbitol – additional 5-10mg/kg

6.Anaesthesia with propofol or midazolam

OTHER AREAS OF TREATMENT

•Exclude hypoglycemia

•Tracheal intubation

•ABG

•Hyperthermic management

Management of Anaesthesia for seizure disorders

Consider impact of drugs on organ function

- Coagulation

- Response to anaesthetic drugs.