Epilepsy Overview and Pathophysiology

A transient occurrence of signs and/or symptoms due to abnormal, excessive, or synchronous neuronal activity in the brain.

A chronic neurological disorder characterized by recurrent epileptic seizures.

A seizure that occurs spontaneously without a known trigger.

A seizure triggered by a specific stimulus, like a flashing light.

The area in the brain where the abnormal electrical activity originates during a seizure.

The clinical presentation of a seizure, determined by the location of the epileptic focus and the pathways involved in its spread.

A diagnostic tool used to measure and record brain activity, often helpful in identifying seizures.

A rhythmic and repetitive hypersynchronous discharge of neurons, either localized or generalized, that characterizes epileptic seizures.

Conditions that mimic epilepsy, but have different causes, like fainting, breath-holding, mini-strokes, or psychological factors.

Seizures triggered by factors like drugs, metabolic issues, infections, head injuries, or flashing lights.

A formal diagnosis of epilepsy requires at least one of the three criteria defined by the International League Against Epilepsy (ILAE).

The diagnosis of epilepsy carries a social stigma, meaning it can impact a person's life and relationships.

MRI scans are crucial for detecting structural brain abnormalities that could cause seizures, like strokes, tumors, or developmental issues.

Convulsive seizures can be frightening, but the person isn't in pain, remembers nothing afterward, and is generally not seriously injured.

Emergency treatment for seizures isn't usually necessary, but comfort measures like lying down, cushioning the head, and loosening clothes should be taken.

During focal seizures, people may exhibit confused behavior called automatisms. Generally, they should be left undisturbed, but gentle restraint may be needed if they become a safety risk.

The primary goal of epilepsy treatment is to control seizures using the lowest effective dose of a single drug, minimizing side effects.

Established AEDs are medications commonly used for epilepsy treatment that were first introduced before the year 2000.

Newer AEDs are medications for epilepsy treatment that were introduced after the year 2000.

The choice of epilepsy medication depends on the type of seizure experienced by the patient.

The initial treatment for newly diagnosed epilepsy involves slowly introducing a first-line antiepileptic drug (AED) suitable for the patient's seizure type.

Inhibiting COMT (catechol-O-methyltransferase) prevents the breakdown of levodopa to an inactive form, allowing more levodopa to reach the brain.

Entacapone and Tolcapone are primarily peripheral COMT inhibitors, meaning they mainly act outside the central nervous system to increase levodopa in the brain.

Tolcapone can cause liver damage (hepatotoxicity) and requires regular monitoring. Entacapone is generally considered safer for liver function.

MAO-B inhibitors like Selegiline and Rasagiline slow down the breakdown of dopamine, effectively extending its effects in the brain.

Amantadine has a variety of mechanisms, including dopamine release enhancement, reuptake blocking, anticholinergic effects, and even weak NMDA receptor antagonism.

Amantadine is commonly used to reduce dyskinesia (involuntary movements) in advanced Parkinson's disease.

Higher doses of MAO-B inhibitors may not lead to much greater inhibition of the enzyme, suggesting a plateau effect.

Entacapone can be used in combination with other anti-Parkinsonian drugs, but caution is needed with apomorphine due to potential for hemolytic anemia.

Sodium valproate is a type of medication used to control seizures, especially those that happen frequently and without a clear cause. It works by affecting different parts of the brain involved in causing seizures.

Sodium valproate can cause side effects such as nausea, diarrhea, weight gain, hair loss, skin rashes, and low blood platelet count.

Doctors usually only check blood levels of sodium valproate if there are concerns about toxicity, worsening seizure control, poor adherence to medication, or drug interactions.

Sodium valproate should be avoided during pregnancy as it can cause birth defects.

Parkinson's disease is a neurological disorder characterized by tremors, stiffness, slowness of movement, and balance issues.

The prevalence of Parkinson's disease increases with age, affecting more people over 80 than those in their 60s.

Parkinson's disease is thought to be caused by a combination of genetic and environmental factors. The exact cause is still unknown.

In Parkinson's, neurons in a specific brain area called the substantia nigra die, leading to a decrease in dopamine, a chemical important for movement control.

A toxic state causing confusion, often associated with high doses of certain medications.

A side effect where the skin on the legs, and sometimes the arms, develops reddish-blue patches, a sign of poor blood circulation.

Drugs that block the action of acetylcholine, a neurotransmitter, often used for tremor reduction.

A serious side effect of antimuscarinic drugs causing slowed thinking and confusion.

A surgical treatment for Parkinson's Disease involving stimulating a specific brain structure.

A surgical treatment for Parkinson's Disease involving destroying a small part of the brain.

A type of surgical treatment aimed at delivering dopamine or related substances directly to the brain.

A vital part of Parkinson's care involving explaining the disease and providing support.