Introduction to Epilepsy
Definition: Epilepsy is a neurological disorder characterized by recurrent seizures due to abnormal electrical activity in the brain. Impact: It affects people of all ages and can significantly impact daily life, including work, education, and social interactions. (Types of Seizures) Generalized Seizures: Involve both sides of the brain and typically affect consciousness. Examples include tonic-clonic (formerly known as grand mal), absence (formerly known as petit mal), and atonic seizures. Focal Seizures: Begin in one area of the brain and can be simple (involving limited consciousness) or complex (affecting awareness and memory). Statistics on Prevalence and Impact Prevalence: Epilepsy affects approximately 50 million people worldwide. Impact: It is associated with increased mortality rates and can lead to physical injuries, cognitive impairment, and psychosocial challenges.
Types of Anti-Epilepsy Drug
Phenobarbital Mechanism: Increases GABA-mediated inhibitory transmission Common Uses: Focal and generalized tonic-clonic seizures Side Effects: Sedation, cognitive impairment, dependence Phenytoin (Dilantin) Mechanism: Stabilizes neuronal membranes by inhibiting sodium channels Common Uses: Focal seizures, generalized tonic-clonic seizures Side Effects: Gingival hyperplasia, hirsutism, ataxia Carbamazepine (Tegretol) Mechanism: Inhibits sodium channels, reducing neuronal firing Common Uses: Focal seizures, generalized tonic-clonic seizures Side Effects: Dizziness, double vision, leukopenia
2nd-Generation Medications
Lamotrigine (Lamictal) Mechanism: Inhibits sodium channels and glutamate release Common Uses: Focal seizures, generalized seizures, Lennox-Gastaut syndrome Side Effects: Rash (including Stevens-Johnson syndrome), dizziness, headache Levetiracetam (Keppra) Mechanism: Binds to synaptic vesicle protein SV2A, modulating neurotransmitter release Common Uses: Focal seizures, generalized tonic-clonic seizures, myoclonic seizures Side Effects: Irritability, dizziness, fatigue Topiramate (Topamax) Mechanism: Blocks sodium channels, enhances GABA activity, inhibits glutamate receptors Common Uses: Focal seizures, generalized tonic-clonic seizures, Lennox-Gastaut syndrome Side Effects: Cognitive impairment, weight loss, paresthesia Other Notable Medications Valproic Acid (Depakote) Mechanism: Increases GABA levels, inhibits sodium channels Common Uses: Generalized seizures, focal seizures, bipolar disorder Side Effects: Weight gain, tremor, liver toxicity Gabapentin (Neurontin) Mechanism: Modulates calcium channels, enhances GABA activity Common Uses: Focal seizures, neuropathic pain Side Effects: Dizziness, fatigue, peripheral edema