MLOHIT PPT FIROZABAD ( BBAU LUCKNOW)

1. PRESENTED BY
MOHIT KUMAR VERMA
MO (PHARMACOLOGY)
DEPTT. OF
Pharmaceutical Science
08/10/2015
Topic is epilepsy
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2. CONTENT
What Is Epilepsy ?
Types of epilepsy and sub-types…
Symptoms of Epilepsy...
Causes of Epilepsy...
EPILEPSY : MACHNISM OF ACTION ...
Diagnosis...
Epilepsy Safety...
Epilepsy and Pregnancy...
CLASSIFICION OF ANTI-EPILEPTIC DRUGS...
Choise of anti-epileptic drugs...
Newer Drugs...
Drugs Mode of action...
Reference ...
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3. What Is Epilepsy ?
Epilepsy is a defined as disorder of neurological condition and
problem with the brain’s electrical system. Electrical impulses cause
brief changes in movement, behavior, feeling. These events, known
as seizures, may last from a few seconds to a few minutes.
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6. 1. Generalized Tonic-Clonic Seizures
Generalized tonic clonic seizures are the most easily recognized. They usually begin
with a stiffening of the arms and legs, and are followed by jerking motions. These
convulsions can last up to 3 minutes. After having one, a person may be tired and
confused. This type of seizure involves both sides of the brain.
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7. PartialSeizures
In partial seizures, just one side of the
brain is affected. A person having a
simple partial seizure may have
jerking motions or hallucinations.
When having a complex partial
seizure, a person may wonder,
mumble, smack their lips, or fumble
with their clothes. He or she may
appear to be conscious .
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8. Symptoms of Epilepsy
Epilepsy is widely known for causing
convulsions,
• Sudden Un-controlled
movements.
• Loss of consciousness.
•Fainting.
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9. Causes of Epilepsy
•Head injury
•Brain infection
•Oxygen deprivation
•Trauma
•Confussion, depressed
• skull fractures.
•Brain tumors (including tuberculoma),
•Drug withdrawal,
e.g. CNS depressants .
•Fever in children (febrile convulsion).
•Hypoglycemia
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10. EPILEPSY : MACHNISM OF ATION
SEIZURES
Anti -epileptic drug
(ESLICARBAZEPINE ACETATE)
1. NEURONS
2. ACTION POTENTIAL ACROSS
CELL SURFACE OF Na+ IONS
3. Action potential
4. Active channels
5. INACTIVATED CHANNELS
6. Na+ CHANNEL ACTIONS
7. NEURONE FIRRING
8. Dipolarised Na+ channel
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11. Diagnosis: Brain Scan And Diagnosis: EEG
Diagnosis: Brain Scan
Detailed images of the brain from CT: computed tomography or
MRI: Magnetic Resonance Imaging scans can help doctors rule out
tumors or blood clots as a cause of seizures. A CT scan is a powerful
type of X-ray, and an MRI uses magnets and radio waves to make
pictures. This information will help your doctor come up with the best
treatment plan for you.
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Diagnosis: EEG
An EEG (Electroencephalogram) can confirm a diagnosis
and give more information about your seizures. It’s a painless
procedure that records the brain’s electrical activity as wavy
lines. The pattern changes during a seizure and may show
which part of the brain is affected. That can help guide
treatment.

13. Epilepsy Safety Precautions
Because seizures often strike without warning, certain activities can be
dangerous. Losing consciousness while swimming or even taking a
bath could be life-threatening. The same goes for many extreme sports,
such as mountain climbing. Most states require you to be seizure-free
for a certain amount of time before driving a car.
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Treatment: Surgery
 If you have partial seizures, surgery may stop them. If the medical team can
determine that your seizures always begin in a single area of the brain,
removing the area may stop them or make them easier to manage. Surgery
may also treat conditions that cause the seizures, such as a brain tumors.
Treatment:
Medication- Anti-seizure , anti -epileptic drugs are the most common treatment
for epilepsy.

15. Epilepsy and Pregnancy
In most cases, it is safe for women with
epilepsy to become pregnant. More than 90% of
babies born to women with epilepsy are healthy.
But if you're planning to get pregnant, talk to
your doctor first. Anti-seizure drugs can cause
risks for infants, and some have more risks than
others. You may need to change or adjust your
medication.
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16. CLASSIFICION OF ANTI-EPILEPTIC DRUGS
CLASS DRUGS
Barbiturate Phenobartitone
Deoxybarbiturate Primidone
Hydantoin Phenytoin
Iminostilbene Carbamazepine
Succinimide Ethosuximide
Aliphatic carboxylic acid Valproic acid
Benzodiazepines Diazepam
Phenyltriazine Lamotrigine
Cyclic GABA analogue Gabapentin
Newer drugs Zonisamide,Topiramate
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17. Choise of epileptic drugs
DrugsSeizure disorder
Carbamazepine or
Valproate or
Phenytoin or
Phenobarbital
Tonic-clonic (Grand mal)
Drug of Choice
Topiramte
Lamotrigine (as adjuvant or alone)
Gabapentin (as adjuvant)
Alternatives:
Carbamazepine or Topiramte or
Phenytoin or
Valproate
Partial (simple or complex)
Drug of choice
Phenobarbital
Lamotringine (as adjuvant or
alone)
Gabapentin (as adjuvant )
Alternatives:
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Valproate or
Ethosuximide
Absence ( petit mal)
Drug of choice
Clonazepam
Lamotrigine
Alternatives:
ValproateMyoclonic, Atonic
Drug of choice
ClonazepamAlternatives:
Diazepam, i.v.
or Phenytoin, i.v. or Vaproate
Status Epilepticus
Drug of choice
Phenobarbital, i.vAlternatives:
Diazepam, rectal*
Diazepam ,i.v
Valproate
Febrile Seizures
* Preferred

19. Topiramate
Vigabatrin,
Levetiracetam,
Lamotrigine,
Zonisamide,
Lacosamide,
Rufinamide
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Newer Drugs

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Mode Of Action (MOA)
Topiramate: It is a sulphamate substituted monosaccharide,
a weak carbonic anhydrase inhibitor has broad spectrum
anti-convulsant activity. It appear to act by multiple
machanisms:
1. Prolongation of Na+ channel inactivation,
2. GABA potentiation,
3. Neuronal hyperpolarization through certain K+
channels.
Indications: Topiramate is a useful adjuvant in refractory
partial or generalized epilepsy and other epileptic
syndromes

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Zonisamide: 1.Weak carconic anhydrase inhibitory action that
modified max. Electroshock seizures and inhibits kindled seizures
2. It has also been found to suppress T-type of Ca+ currents in certain
neurons.
Tiagabine: It’s neuronal inhibitor by depressing GABA trasportor
GAT-1 which remove synapticalliy released GABA into neurones
and glial cells

22. REFERENCES By-
1. Ferrándiz-Pulido C, García-Fernández D, Domínguez- Sampedro P,
García-Patos V. Stevens-Johnson syndrome and toxic epidermal necrolysis
in children: a review of the experience with paediatric patients in a
university hospital. J Eur Acad Dermatol Venereol.
2. Brunklaus A, Ellis R, Reavey E, Forbes GH, Zuberi SM. Prognostic,
clinical and demographic features in SCN1A mutation-positive Dravet
syndrome. Brain.
3. K.D. Tripathi, Essentials Medical Pharmacology ” seventh edition”-
2013 page no. 411-416.
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