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Risk Factors, TBL 8.3 MECHANISTIC DIAGRAM, Gerry Guo, Kara Harris,…
Risk Factors
21 years old
Sleep deprivation
Fatigued before seizure onset
Adequate rest to avoid
Family history (maternal cousin with seizures)
Genetic link
Ion channelopathy
JUVENILE MYOCLONIC EPILEPSY
Abnormal EEG
3-6 Hz polyspike and wave
Increased excitation and decreased inhibition of neurons
Loss of consciousness
Confusion
Clonic: rhythmic jerking of limbs
Tonic-clonic seizure
Biting of lateral tongue
Bloody spit
Overactivity in para-central region of brain
1-3 minutes in duration
Tonic: stiffening of limbs
Gasping/groaning
Overactivity in insular cortex
Myoclonic jerks in the morning
GABA receptor subunit gene
Sodium valproate
works via mechanism 1, 2 and 5
Inhibits sodium channels, inhibits calcium channels & enhances GABA levels in CSF
Titre dose to minimise side effects and aim for seizure remission
Side effects: fairly well tolerated but may have dizziness, upset stomach, headache, tremor, weight gain, hair loss
Treat via. zarontin - inhibits calcium channels in thalamus, crucial for generalized seizure pathway
Gene testing?
Started at 12, possibly juvenile myoclonic seizure
Commercial heavy vehicle licence
10 years seizure-free with normal EEG before resuming
Support and advice concerning work
6 months seizure-free before resuming driving with private licence
Video gaming
Flashing lights
Binge drinking
Cessation
TBL 8.3 MECHANISTIC DIAGRAM
Gerry Guo, Kara Harris, Mohammed Hassan, Christy Hou & Daniel Kasunic