Challenge 2010

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Lecture Notes

Lecture Title : Epilepsy Prof name : Dr.Mostafa Shihebat Done by : Pharmacy students Corrected by : Dentistry students

Epilepsy

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Epilepsy
First we must differentiate between epilepsy and seizure: Seizure ) :( it is a pretemporary disturbance in the electrical activity and excessive neuronal discharge and it is the symptom of epilepsy disorder .

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Epilepsy ) : (it is a chronic neurologic disorder, characterized by a seizures . Remind that neurotransmitters are: 1-exitotary, for example : glutamate and aspartate 2-inhibitory, for example : GABA (-aminobutyric acid) =gama

when there is an excessive secretion of excitatory neurotransmitters or imbalance between excitatory and inhibitory neurotransmitters , this will lead to epilepsy , so we can say that the cause is some neuronal cells fire abnormally.

Epilepsy

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- if a person has one seizure , can we say that he has epilepsy

? No, because ti one time seizure, if he stay for 2-3 years without recurrent of other once , he is not an epileptic patient , so the seizure must recurrent to consider epilepsy .

- 90% of epilepsy occurs in developing countries, and the average age of epileptic patient is 25 yr. old, however, any age can get epilepsy any time . There are many people with epilepsy who are within the age 6 to 10 years. So there is no limited age for epilepsy, it could happen to old or young people.(50% epilepsy happens at the age of 25) The brain is the source of epilepsy , all brain functions like moving muscles ,thinking, seeing, feeling and others are depend on electrical signals that pass between neurons in the brain . Seizures occur when too many nerves in the brain fire too quickly causing an electrical store.

causes of epilepsy: 1) 70% of epileptic people with unknown . 2) 30% have known causes: 1. trauma in the head )(

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2. Infections in brain like meningitis. 3. Heredity, genetic mutation. Let us talk about genetic mutation: Some genetic mutations may occur in the genes that code for sodium channel proteins; these defective sodium channels stay open for too long, so more Na enter the post synaptic and Glutamate, an excitatory neurotransmitter, may, therefore, be released in large amount , so the excitation increased in the post synaptic neurons .

, , , , , , .
Seizures are classified into 2 types:

Generalized seizure

Partial ( or localized ) seizure

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Involve all the brain and include loss of consciousness

The source of charges is only a part from the brain , it may include loss of consciousness or not ,usually it can be marked by jerking of eyes only

Very important note :

Source of seizures it may be any region in the brain , but some regions are more susceptible to cause seizures , the most important region is the Hippocampus which is responsible for short term memory , long term memory , spatial navigation.

The Hippocampus, which contains a large volume of just such glutamate ( excitatory neurotransmitter) , is especially vulnerable to epileptic seizure and subsequent spread of excitation , so it is considered as a major source of epilepsy .

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symptoms that indicate a seizure disorder :

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1. 2. 3. 4. 5.

(it is vary from one to other ,depending on the seizure type ) The most important one is, the recurrence of seizure. Sudden falls for unknown reason. Confused memory, emotional disorders. Visual and hearing disorders . Convulsion or not ,( dont forget that generalized epilepsy is always associated with convulsion) .

6. Lip smashing, chewing, repetitive and involuntary but coordinated movement, muscular contraction of the face. 7. Muscle rigidity, spasm, head turning, eye jerking (blinking). The duration of a seizure it may range from 1-2 minutes , it may happened only by jerking eyes , it depend on the seizures type and the region in the brain that considered the source of the electrical changes .

Treatment :

Epilepsy is not curable , treatment is for controlling only , that means , instead of having one episode ) ( every week , it will be every 3 years . -Epilepsy is not shameful. -It doesnt effect the IQ of person , and doesnt cause any mental retardation in general .
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- How to diagnosis epilepsy? 1) ECG , but it may appear normal in some epileptic patient 2) MRI (Magnetic resonance imaging) . 3) CG scan = computed tomography scan .

What to tell your doctor if you have epilepsy ?

Tell him about symptoms patterns , how you felt after the episode and preseizure activity.

What propagate epilepsy?

1) There is 2 important factors: flashing of lights, photosensitivity and Hyperventilation. 2) Stress and anxiety. 3) Hormonal changes. 4) Lack of sleep. 5) Menses (menstrual cycle ). 6) Mismedication.

Treatment may be by medications or by surgery which used to remove the hyper active region in the brain. How o help an epileptic patient? First and the most important thing is to keep the airways opened , and put something rubber to bite by his teeth in order not to bite his tongue or cut it and to avoid any
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Epilepsy

thing may stop his breathing . (shoes), as Doctor mentioned as an example for the previous case.

avoid any thing may harm him like knives , sharp things. In the hospital , they may give him( IV) Na- thiopental or pentothal which is short rapid acting Barbiturates . that are a class of drugs that act on the GABAA receptor in the CNS. We know that GABA have inhibitory action that antagonize ) ( the excitatory action , then it decrease and prevent the neuronal hyperactivity Barbiturates have anxiolytic ) ( and anticonvulsant
) . ( ) )

GOOD LUCK

Epilepsy

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