Epilepsy, seizure disorders, CNS disorder, Pathophysiology, Pathogenesis, D.Pharm, B.Pharm, Definition, Types, Etiology, Pathogenesis, Etiopathogenesis, Clinical Manifestations, Diagnosis, Pharmacological and Non Pharmacological treatments.

1. CENTRAL NERVOUS SYSTEM
DISORDERS
EPILEPSY
A PRESENTATION BY:
AMAN GUPTA
LECTURER
GCRG COLLEGE OF PHARMACY, LUCKNOW
NCJ @ AMAN

2. EPILEPSY
WHAT IS EPILEPSY?
• A DISORDER OF CENTRAL NERVOUS SYSTEM.
• EPILEPSY = SEIZURE DISORDER.
• UNPREDICTABLE SEIZURE RECURRING = EPILEPSY
• UNPREDICTABLE = WHICH OCCURS SUDDENLY & CAN NOT BE PREDICTED.
• RECURRING = TO OCCUR AGAIN OR MANY TIMES.
WHAT IS SEIZURE?
SEIZURE = FROM WORD “ SEIZE” = TO SEIZE SOMETHING OR TO TAKE CONTROL OF
SOMETHING.
SEIZURE= SUDDEN UNCONTROLLED ELECTRICAL DISTURBANCE IN THE BRAIN.

3. Seizure= sudden uncontrolled electrical disturbance in the brain.
Leading to various effects inside the Body;
These effects depends upon the area of brain where seizure has occurred.
Such as:
•Loss of consciousness.
•Muscle stiffening.
•Tongue biting.
•Falling.
•Convulsions.
•Tremors [uncontrolled shaking]
•Black out or Lost in space.
•Loss of Bladder control.

4. CENTRAL NERVOUS SYSTEM

5. CNS DURING EPILEPSY
SUDDEN ELECTRICAL DISTURBANCE = EXCESSIVE FIRING OF NEUROTRANSMITTERS.
NEURONS TRANSMITS NERVE IMPULSES INSIDE THE BRAIN.
THESE NERVE IMPULSES ARE IN THE FORM OF ELECTRICAL IMPULSE.

7. DEFINITION
EPILEPSY= DERIVED FROM THE GREEK WORD ‘EPILEPSIA’ MEANING "TO SEIZE” WAS FIRST USED
BY HIPPOCRATES. NCJ @ AMAN
EPILEPSY IS ABNORMAL, RECURRENT, SUDDEN ELECTRICAL DISCHARGE FROM THE BRAIN
(OFTEN IN THE CEREBRAL CORTEX) THAT RESULT IN CHANGES IN SENSATION, BEHAVIOR,
MOVEMENTS.
OR
IT IS A NEUROLOGICAL DISORDER MARKED BY SUDDEN RECURRENT EPISODES OF SENSORY
DISTURBANCE, LOSS OF CONSCIOUSNESS, OR CONVULSIONS, ASSOCIATED WITH ABNORMAL
ELECTRICALACTIVITY IN THE BRAIN.
SEIZURE= A SEIZURE IS A SYMPTOM OF AN ELECTRICAL DISTURBANCE IN THE BRAIN. IT CAN
LEAD TO LOSS OF CONSCIOUSNESS, DISTURBANCE OF MOVEMENT, MUSCLE SPASMS.

8. TYPES OF EPILEPSY NCJ @ AMAN
PARTIAL SEIZURE/FOCAL SEIZURE GENERALIZED SEIZURE

9. PARTIAL/FOCAL SEIZURE/EPILEPSY
1. SIMPLE PARTIAL SEIZURE (SPS).
2. COMPLEX PARTIAL SEIZURE (CPS).
GENERALIZED SEIZURE/EPILEPSY
( Trick To Remember: Maagi)
1. MYOCLONIC SEIZURE.
2. CLONIC SEIZURE.
3. ATONIC SEIZURE.
4. TONIC SEIZURE.
5. ABSENCE SEIZURE.
6. GENERALIZED TONIC-CLONIC SEIZURE.
7. INFANTILE SEIZURE.

10. PARTIAL SEIZURE/FOCAL SEIZURE = Uncontrolled Neuron Firing Occurs
In Only One Part/One Point Of Brain.
Since Seizure Occurs In Only One Part/Point, Patient Does Not Looses
Consciousness.
GENERALIZED SEIZURE = Uncontrolled Neuron Firing Occurs In Whole
Brain.
Since Seizure Occurs In Whole Brain, Patient Looses Consciousness.

11. Partial Seizure (Focal Seizure)
• A Partial Seizure Does Not Involves Whole Brain.
• It Begins In A Particular Area Only Hence Called Focal Seizure.
• It Is Limited To A Part Of One Brain Hemisphere.
• There Is A Site, Or A Focus, In The Brain Where The Seizure Begins.
a. Simple Partial Seizure (Jacksonian Seizures):
Convulsions occurs only in some group of muscles  depending upon which part of brain is affected due to
seizure.
It usually occurs for 1-2 minutes.
b. Complex Partial Seizure (Temporal Lobe Epilepsy):
This Attack Lasts For 2-5 Minutes.
The Focus Is Located In Temporal Lobe.
It Is Characterized By Sudden Onset Of Impaired Consciousness, Purposeless Movement, Emotional Changes,
Aimless Walking Etc.
NCJ @ AMAN

12. SOME COMMON TERMS
AURA = Feeling Before Seizure; Feeling That A Seizure Attack Could Happen. (For Ex: Nausea
Before Vomit).
TONIC SEIZURE = All Skeletal Muscles Of Body Gets Stiff (Hard/Freeze); Patient Gets
Unconscious And Falls Backwards.
ATONIC SEIZURE = All Skeletal Muscles Of Body Gets Relaxed (Loose); Patient Gets Unconscious
And Falls Forward.
CLONIC SEIZURE = Rapid Contraction And Relaxation Of Skeletal Muscles Of Whole Body;
Convulsions.
TONIC-CLONIC SEIZURE = Muscle Stiffness And Convulsions.
MYOCLONIC SEIZURE = Twitches (Tremor/Vibration) In Some Parts Of Muscles In Any Organ
Or Sometimes Whole Body.
ABSENCE SEIZURE = Complete Blackout/Lost In Space/Freeze Suddenly. Starring At One Place.

13. Generalized seizure
it involves production of abnormal electrical activity throughout brain and leads to immediate loss of consciousness.
a. Absence seizures: Absence seizures, previously known as petit mal seizures, often occur in children and are
characterized by blackout, lost in space, staring into space or subtle body movements such as eye blinking or lip
smacking. These seizures may cause a brief loss of awareness. (15-20 sec)
b. Tonic seizures: Tonic seizures cause stiffening of your muscles. These seizures usually affect muscles in your back,
arms and legs and may cause you to fall to the ground backwards and loss of consciousness. (15-20 sec)
c. Atonic seizures: Atonic seizures, also known as drop seizures, cause a loss of muscle control or sudden muscle
relaxation, which may cause you to suddenly collapse or fall down forwards. (20-30 sec)
d. Clonic seizures: Clonic seizures involves rapid contraction and relaxation of skeletal muscles of whole body leading to
convulsions. (1-2 min)
e. Tonic-clonic seizures: Tonic-clonic seizures, previously known as grand mal seizures, are the most dramatic and
common type of epileptic seizure and can cause an abrupt loss of consciousness, body stiffening and shaking. (1-2
min)
Aura Unconsciousness Tonic spasm Clonic jerking/convulsions.
f. Myoclonic seizures: Twitches (tremor/vibration) occurs in some parts of muscles in any organ or sometimes whole
body. Rapid convulsions occurs in muscles (commonly hand and legs) like a shock. (5-10 sec)
g. Infantile spasm seizure: Rapid spasm of muscles in infants. (1-5 sec)
[ Petit mal = french = small ; Grand mal = big]
{[[[[[[[[NCJ @ AMAN

14. ETIOLOGY OF EPILEPSY
The exact cause of epilepsy may not be known, the more common seizures are caused by the following:
1. Head trauma: Head trauma as a result of a car accident or other traumatic injury can cause epilepsy.
2. Brain condition: Brain conditions that cause damage to the brain, such as brain tumours or strokes, can cause epilepsy.
Stroke is a leading cause of epilepsy in adults older than age 35.
3. Infectious diseases: Infectious diseases, such as meningitis, aids and viral encephalitis can cause epilepsy.
4. Prenatal injury: Before birth, babies are sensitive to brain damage that could be caused by several factors, such as an
infection in the mother’s body, poor nutrition or oxygen deficiencies. this brain damage can result in epilepsy.
5. Developmental disorders: Epilepsy can sometimes be associated with developmental disorders.
Other possible causes of seizures may include:
Brain tumour
Cranial surgery
Metabolic disorders
Drug toxicity
CNS infection etc. NCJ @ AMAN

15. PATHOPHYSIOLOGY OF EPILEPSY
PRECIPITATING FACTORS ETIOLOGICAL FACTORS FAMILY HISTORY
[loud noises or bright lights] [change in neuronal activity] [genetic factors]
Hyperactivity of neurons in various areas of brain
Partial depolarization [irregular electrical discharge]
Imbalanced release of neurotransmitters
Sudden electrical discharge from brain leading to
EPILEPSY attack depending upon part of brain affected.
NCJ @ AMAN

16. CLINICAL MANIFESTATIONS OF EPILEPSY
Because epilepsy is caused by abnormal activity in the brain, seizures can affect any process of the brain.
Seizure signs and symptoms may include:
• Temporary confusion.
• A staring spells [looking into empty space; patient suddenly stops all activity; more commonly seen in
children].
• Uncontrollable jerking movements of the arms and legs.
• Loss of consciousness or awareness.
• Psychic symptoms such as fear, anxiety.
Symptoms vary depending on the type of seizure. In most cases, a person with epilepsy will tend to have the
same type of seizure each time, so the symptoms will be similar from episode to episode.
NCJ @ AMAN

17. DIAGNOSIS OF EPILEPSY
• A neurological examination
• Blood test to check for signs of infection, genetic condition or other conditions.
• Electroencephalogram (EEG)
• Computerized tomography (CT) Scan
• Magnetic Resonance Imaging (MRI)
NCJ @ AMAN

18. TREATMENT OF EPILEPSY
Pharmacological treatment:
• Carbamazepine
• Diazepam
• Ethosuximide
• Phenytoin
• Phenobarbital
• Valproic Acid
• Primidone
NCJ @ AMAN

19. THANK YOU
NCJ @ AMAN