Seizures Essay

649 words - 3 pages

Final Paper-SeizuresSeizure:1) A sudden attack, spasm, or convulsion, as in epilepsy or another disorder.2) A sudden onset or sensation of feeling or emotion.In this case, we are talking about the kind of seizure associated with Impaired consciousness and awareness of surroundings. This is called a Complex Partial Seizure.In the US: For people younger than 60 years, the incidence of partial seizures is 20 per 100,000 person-years. For people aged 60-80 years, incidence increases to 80 per 100,000 person-years. Prevalence of epilepsy is 0.5-1 per 100 persons. Complex partial seizures occur in about 35% of persons with epilepsy.Causes:Possible causes of complex partial seizures include the following:Brain traumaEncephalitisMeningitisStrokePerinatal brain injuriesVascular malformationsCortical dysplasiaNeoplasmsComplex partial seizures in most patients represent a symptom of underlying temporal lobe epilepsy, the cause of which is unknown. Characteristic pathologic changes termed mesial temporal sclerosis are most often visible on brain MRI.Medical Care:Anticonvulsant therapy generally is indicated when patients have more than one seizure.The goal is to make the patient seizure free.Even one seizure per year may prevent the patient from working and/or driving.Monotherapy generally is considered to be preferable to therapy with 2 or more anticonvulsants. Cognitive side effects are common with anticonvulsants.The newer anticonvulsants, gabapentin, lamotrigine, tiagabine, and topiramate, have the following characteristics:Are more costly than older anticonvulsantsAre excellent drugs to use when treatment with 2 anticonvulsants is needed, because they have minimal hepatic drug interactionsDo not require serum drug-concentration monitoringHave a high therapeutic indexAre well tolerated and can be used at doses greater than the maximum recommended doseAlthough many anticonvulsants are listed as category D (unsafe in pregnancy), continuing to take anticonvulsants during pregnancy is usually safer for women who require these drugs for seizure control.Phenytoin and valproate have the following characteristics:Bind strongly to serum proteinsRequire free drug levels if the patient is pregnant or has abnormal serum proteins (eg, hepatic and/or renal...

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