Affy MD
Mind Map by , created over 6 years ago

Pham1056 Mind Map on Epilepsy, created by Affy MD on 04/25/2013.

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Affy MD
Created by Affy MD over 6 years ago
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Epilepsy
1 Partial Seizures

Annotations:

  • May lead to Secondary Generalized Serizure
1.1 Simple

Annotations:

  • Without alteration of conciousness
1.2 Complex

Annotations:

  • With alteration of consciousness
1.3 Secondarily Generalized Seizures

Annotations:

  • Loss of consciousness. Involves both hemispheres. Tonic (extending rigidity) and clonic (jerking extremities) phases
1.4 Medication
1.4.1 Carbamazepine

Annotations:

  • Fewer side-effects than phenytoin Well absorbed Strong enzyme-inducing agent- many interactions with other drugs 
  • Side effects include sedation, ataxia, mental disturbances, mild generalised erythematous rash and water retention
1.4.2 Valproate

Annotations:

  • Increases GABA by: (i) Weak inhibitor of enzymes that inactivate GABA, such as GABA transaminase. (ii) May stimulate synthesis of GABA (iii) May decrease GABA turnover (iv) weak blocker of Na+ channels (v) May block NMDA-mediated responses
  • • Side effects include baldness, teratogenicity, weight gain and liver damage - liver function should be managed • Valproate has metabolic effects and increases plasma lamotrogine levels • There may be an increased risk of poly-cystic-ovary syndrome associated with valproate
1.4.3 Phenytoin

Annotations:

  • Acts mainly by block of Na+ channels • Metabolism of phenytoin shows the characteristic of saturation • Range of plasma concentration for effectiveness prior to the appearance of side effects is ~40-100 μmol/l
  • Side effects begin to appear at plasma concentrations of ≥100 μmol/l and severe reactions at plasma concentrations of ≥150 μmol/l) Side effects include confusion, gum hyperplasia, skin rashes, anaemia and teratogenesis 
2 Primarily Generalized Seizures
2.1 Absence (Petit Mal)

Annotations:

  • Brief interruption of consciousness <10 seconds
2.1.1 Medication
2.1.1.1 Ethosuximide

Annotations:

  • Mechanisms of action: Blocks of T-type Ca2+ channels • Side effects include nausea and anorexia • Cautions include avoiding abrupt withdrawal, hepatic and renal impairment
2.1.1.2 Lamotrigine
2.1.1.3 Valproate
2.2 Tonic-clonic (Grand Mal)

Annotations:

  • Sequences of tonic and clonic phases
2.2.1 Medication
2.2.1.1 Valproate
2.2.1.2 Carbamazepine
2.2.1.3 Lamotrigine

Annotations:

  • Mechanism of action: -Blocker of Na+ channels -Inhibits the release of glutamate • Effective in treating absence epilepsy • Side effects include sedation, dizziness, ataxia and skin rashes (Stevens-Johnson syndrome) • Cautions include close monitoring in the effect of skin rashes, consideration for withdrawal
2.2.1.4 Phenytoin
2.3 Myclonic

Annotations:

  • Sudden involuntary muscle contraction
2.4 Atonic

Annotations:

  • Loss of muscle tone
3 Status Epilepticus

Annotations:

  • Continuous seizures lasting at least 30 minutes.
3.1 Medication
3.1.1 Lorazepam

Annotations:

  • High potency benzodiazepine  •Tolerance and dependance can develop from long term administration •Mechanism of action: positive allosteric modulator of GABA(A)receptors •Side effects include sedation and withdrawal symptoms
3.1.2 Diazepam

Annotations:

  • Tolerance can develop with long term administration • Mechanism of action: positive allosteric modulator of GABA(A) receptors • Side effects include sedation and withdrawal symptoms
3.1.3 Clonazepam

Annotations:

  • Tolerance can develop •Mechanism of action: positive allosteric modulator of GABA(A)receptors •Side effects include sedation and withdrawal symptoms

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