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  Epilepsy

Epilepsy is a neurological disorder in which the patient experiences recurrent seizures consisting of transient disturbances of cerebral function due to paroxysmal neuronal discharges.

Epilepsy
Epilepsy


Seizure disorders especially those occurring during childhood, are often idiopathic. Seizures can be induced by cerebral trauma, infection, vascular disease, neoplasms, degenerative diseases such as Alzheimer disease, drug and chemical intoxication, metabolic disorders (renal failure, hypoglycemia), and in children, high fever (benign febrile convulsions). In patients with idiopathic epilepsy, seizures may be triggered by physical and emotional stress, lack of sleep, fever, drugs, alcohol, alcohol withdrawal, menstruation, or flashing lights.

Epilepsies can also be classified on the basis of the clinical presentation of symptoms. Initially, it is organized according to the source of the seizure within the brain whether it is localized (partial or focal onset seizures) wherein only part of one cerebral cortex is involved or distributed (generalized seizures) in which the entire cerebral cortex is involved. Partial seizures are further divided depending on whether the patient is conscious or not during the seizure attack. Complex is sometimes presenting with psychic symptoms or automatisms and accompanied by impaired alertness or unconsciousness. Simple seizures are usually presented with local twitching or jerking; perception of flashing lights or other abnormal sensory phenomena but no unconsciousness is involved.

Absence or petit mal is a type of seizure characterized by a brief loss of attention and perception. Tonic-clonic or grand mal type of seizure has both the tonic and clonic phase. In the tonic phase, the patient becomes rigid, loses consciousness, falls and stops breathing. In the clonic phase, the patient has generalized muscular jerking, may bite the tongue or lips and may have urinary and fecal incontinence. In the postictal phase, after awakening, the subject is drowsy and may be amnesic temporarily. Cyclonic seizure is defined as repeated shock like, often violent contractions in one or more muscle groups. Status epilepticus is one or more series of grand mal seizures lasting more than 30 minutes without waking intervals.

In between seizures there is no detectable abnormality. Signs of neurologic disease may be found in secondary epilepsy. Diagnosis of epilepsy is usually based on the medical history. To rule out treatable underlying causes, the affected region and to classify the type of seizure, the following laboratory diagnostic imaging procedures are useful: EEG, brain CT scan or MRI, SPECT, PET and magnetoencephalography. The long-term video-electroencephalogram monitoring for epilepsy is the gold standard for diagnosis but it is not routinely employed due to its high cost, availability and inconvenience.

An increase incidence rate has been found among ages under 18 and over the age of 65. It some situations which can lead to an increase likelihood of seizures are those diagnosed with epilepsy or in certain syndromes. These situations include: during sleep, transition between sleep and wake, tiredness, illness, constipation, menstruation and stress.

The goal of pharmacologic treatment is to prevent occurrence of seizures or reduce the frequency of attacks. The class of drugs used to treat seizures is termed as “anticonvulsant” or “antiepileptic” agents. All of these drugs have possible side effects which are idiosyncratic and others are dose-dependent. If complete remission does not occur when treated with a particular anticonvulsant drug despite reaching the therapeutic level then the strategy is to increase the dose of the drug or another medication from another class may be added to the first. Generally, the rule is to increase the dose of the medication until either the seizures are controlled, or until side effects appear which necessitates shifting to another drug class. Common anticonvulsant drug class belongs to: barbiturate (e.g. Phenobarbital), benzodiazepine (e.g. Valium) or the succinimide group. Surgical treatment is only an option for epilepsy with an underlying organic brain problem such as a benign tumor that can be excised by a neurosurgeon.

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Diazepam tablets

Diazepam

Diazepam, one of a group of drugs known as Benzodiazepines, is a Central Nervous System (CNS) depressant. Diazepam is used as an Amnestic, an Anitanxiety Agent, Anticonvulsant, an Antipanic and Antitremor Agent, a Sedative, and Muscle Relaxant. It is used more...

Valium tablets

Valium

Valium, may also be called Diazepam, and is one of the Benzodiazepine group of medicines. These are Central Nervous System (CNS) depressants and are used to relieve anxiety. Valium is also used to help relax muscles or relieve muscle spasm. Valium injecti more...

Neurontin capsules

Neurontin

Neurontin, also known as Gabapentin, is used to help control some types of seizures in the treatment of epilepsy. It is also used to manage pain that occurs after shingles, a condition known as Postherpetic Neuralgia. Be sure to tell your doctor of any more...

Phenytoin

Phenytoin

Phenytoin is an anti-epileptic. It works by slowing down impulses in the brain that cause seizures. Phenytoin is used to control seizures. You may not be able to take phenytoin, or you may require a lower dose or special monitoring during treatment i more...

Gabapentin capsules

Gabapentin

Gabapentin, also known as Neurontin is used to help control some types of seizures in the treatment of epilepsy. It is also used to manage pain that occurs after shingles, a condition known as Postherpetic Neuralgia. Be sure to tell your doctor of any more...

Lamictal tablets

Lamictal

Lamictal, or Lamotrigine, is used to help control some seizures in the treatment of epilepsy. It can also be used in the treatment of bipolar disorder in adults older than 18 years of age. Be sure to tell your doctor of any allergies you have whether i more...

Depakote tablets

Depakote

Depakote, also called Divalproex, belongs to a class of medicines called Anticonvulsants that are used in the treatment of epilepsy. Depakote is also an Antimanic, and is used to treat the manic phase of bipolar disorder, and as a deterrent to migraine he more...

Dilantin capsules

Dilantin

Hydantoin anticonvulsants like Dilantin (Phenytoin) are used most often in the treatment of Epilepsy. Dilantin is also used as an Antiarrhythmic, an Antineuralgic, and a Muscle Relaxant. Dilantin works in the Central Nervous System (CNS) to reduce the sym more...

Temazepam capsules

Temazepam

Temazepam, one of a group of drugs known as Benzodiazepines, is a Central Nervous System (CNS) depressant. Temazepam is used as an Amnestic, an Anitanxiety Agent, Anticonvulsant, an Antipanic and Antitremor Agent, a Sedative, and Muscle Relaxant. It is us more...

Topamax tablet

Topamax

Topamax, or Topiramate, is used to control some seizures in the treatment of epilepsy. It is also used to help prevent migraine headaches in adults. Be sure to tell your doctor of any allergies you have whether it is to medication or food, preservative more...


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