Slide 2: Brain regions and neuronal pathways Certain parts of the brain govern specific functions. Point to sensory, motor, association and visual cortex to highlight specific functions. Point to the cerebellum for coordination and to the hippocampus for memory. Indicate that nerve cells or neurons travel from one area to another via pathways to send and integrate information. Show, for example, the reward pathway. Start at the ventral tegmental area (VTA) (in magenta), follow the neuron to the nucleus accumbens, and then on to prefrontal cortex. Explain that this pathway gets activated when a person receives positive reinforcement for certain behaviors (&quot;reward&quot;). Indicate that you will explain how this happens when a person takes an addictive drug.
Convulsions: motor manifestations, may or may not be present during seizures, excessive neuronal discharge. Convulsions appear in Simple Partial and Complex Partial Seizures if the focal neuronal discharge includes motor centers; they occur in all Generalized Tonic-Clonic Seizures regardless of the site of origin. Atonic, Akinetic, Absence Seizures are non-convulsive
Glycine (GLY) binding enhances the ability of GLU or NMDA to open the channel.
Agonists: NMDA, AMPA, Kianate.
Mg ++ Na + AGONISTS GLU Ca 2+ K + GLY www.freelivedoctor .com
Chemical Structure of Classical Antiseizure Agents
X may vary as follows:
Barbiturates - C – N -
Hydantoins - N –
Oxazolidinediones – O –
Succinimides – C –
Acetylureas - NH 2 –*
*(N connected to C2)
Small changes can alter clinical activity and site of action. e.g. At R1, a phenyl group (phenytoin) confers activity against partial seizures, but an alkyl group (ethosuximide) confers activity against generalized absence seizures . www.freelivedoctor .com
Status epilepticus exists when seizures recur within a short period of time , such that baseline consciousness is not regained between the seizures. They last for at least 30 minutes. Can lead to systemic hypoxia, acidemia, hyperpyrexia, cardiovascular collapse, and renal shutdown.
The most common, generalized tonic-clonic status epilepticus is life-threatening and must be treated immediately with concomitant cardiovascular, respiratory and metabolic management.