Please enable JavaScript.

Coggle requires JavaScript to display documents.

8.3: But it was just a little blackout, 2 year PHx of myoclonic jerks of…

- - - - Education
        
        Avoid driving, swimming alone, driving heavy machinery, working at heights
        
        Educating family/friends on seizure first aid: clearing the area around the patient to limit injury, try to place the patient in the recovery position
      - EEG to uncover underlying electrical conductance disorder
      - Treat injured tongue
    - - Avoid risk factors
        
        Lack of sleep, stress, alcohol
        
        Must not drive for at least 6 months without having a seizure
        
        Avoid dangerous workplace tasks for at least the first 6 months after first seizure
      - Pharmacological
        
        Valproic acid (Sodium valproate)
        
        Lamotrigine
        
        Levetiracetam
        
        Topiramate, zonisamide, or clonazepam
      - Monitoring (EEG)
      - Managing side effects of long term medication
        
        Regular exercise and healthy diet to avoid weight gain (valproate side effect)
        
        Adequate sunlight exposure and vitamin D supplements if necessary to prevent osteoporosis (valproate side effect)
- - - - Integration of inputs at the axon hillock leads to AP firing and transmission along the axon via Na+ channels
        
        Change in membrane potential leads to Ca2+ channel opening and Ca2+ influx
        
        Ca2+ causes synaptic vesicle fusion with the pre-synaptic membrane, leading to NT release
        
        Activation of receptors on the post-synaptic membrane
        
        Downstream effects in the post-synaptic cell
        
        Widespread activation of neurons
        
        2 more items...
        
        Re-uptake by astrocytes or pre-synaptic neurons via specific transporters
        
        GAT1 inhibitor (Tiagabine)
        
        Degradation by enzymatic breakdown
        
        GABA transaminase inhibitor (vigabatrin)
        
        1 more item...
        
        Receptor antagonist (Perampanel - AMPA receptor)
        
        Binds to neuronal SV2A protein and also inhibit presynpatic CaV channels) to reduce neuronal excitability (levetiracetam, brivaracetam)
        
        T-type Ca2+ channel blocker (ethosuximide)
        
        Inactivation of voltage-gated Na+ channels (phenytoin, carbamazepine, lamotrigine)
        
        Valproate
        
        Topiramate - AMPA/kainate receptor
        
        Felbamate - NMDA receptor
      - Enhance action of GABA (barbiturates, benzodiazepines)