Epileptic attacks

Chang CK, Lin MT. DL-Tetrahydropalmatine may act through inhibition of amygdaloid release of dopamine to inhibit an epileptic attack in rats. Neurosci Lett 2001 307 163-166. 

Phenytoin is an anti-epileptic drug. Patients taking anti-epileptic drugs are advised to take the medicine routinely, as directed, to stabilise and to avoid epileptic attacks as much as possible. Phenytoin has a narrow therapeutic index so it is important to identify side-effects. It may cause blood disorders. Patients are therefore advised to report immediately any symptoms of bruising or unexplained bleeding. Visual symptoms as a result of phenytoin do not commonly occur. Their occurrence may indicate overdosage. 

The initiation of an epileptic attack involves "pacemaker" cells these differ from other nerve cells in their unstable resting membrane potential, i.e a depolarizing membrane current persists after the action potential terminates. 

Mephobarbital is used as a sedative agent for relieving anxiety and tension as well as for major and minor epileptic attacks. Synonyms for this drug are barbefenal, enfenemal, and methylphenobarbital. 

Chlorazepate is among the long-acting tranquilizers used upon the same indications as other tranquilizers, and also as an adjuvant drug for epileptic attacks. The most common synonyms are tranxene, noctran, and others. 

Phenytoin is used primarily in the treatment of major epileptic attacks. Difhydan, alepsin, dilantin, and solantin are the primary synonyms for phenytoin. 

Ethotoin is less active and less toxic than phenytoin. It is used for the same indications as is phenytoin, i.e. for control of major and complex epileptic attacks. 

Phenobarbital noticeably reduces the excitation of motor centers of the brain, and therefore is used in treating both minor and major epileptic attacks, chorea, and spastic paralysis. Luminal, adonal, seconal, and many others are synonyms for this drug. 

Carbamazepine is used principally for major epileptic attacks. It is not effective enough for minor attacks. There are data showing a number of side effects. A synonym of carbamazepine is tegretol. 

Acetazolamide is a weak diuretic with limited use in edema associated with cardiac insufficiency, glaucoma, minor epileptic attacks, and altitude sickness. Synonyms of this drag are midamor, modamide, cetazol, diamox, dicarb, and others. 

Bini L. Experimental researches on epileptic attacks induced by electric current. Am J Psychiatry 1938 94[May Suppl] 172-174. 

Crotti, Epileptic Attacks as Manifestations of Industrial Intoxication by Trimethylenetrinitra-mine (T4) , MedLavoro 40,107 (1949)... 

Up to 1979 it was estimated that some 360 000 cases of myelographies had been performed with metrizamide and that there had been 40 cases of epileptic attacks after its use (95) although they tended to relate to investigations in the upper part of the spine, three related to cases of lumbar myelography a further case was later described. In some of these instances the use of other drugs may... 

Barsotti M, Crotti G. 1949. [Epileptic attacks as manifestations of industrial intoxication caused by trimethylenetrinitroamine (T4).] Med Lav 40 107-112. (Italian)... 

M, cJ/andra Glox. Maityniaceae lnd, Pak fruit epileptic attacks decoction 131... 

The role of midline and intralaminar thalamic nuclei in the genesis and propagation of epileptic attacks was proposed long ago on the basis of clinical observations [Penfield and Jasper, 1954). Although the controversy on the anatomical initiation of the epileptic attacks remains, there seems to be an agreement that the thalamocortical interactions are essential in the development of most of them [Pollen et al., 1963 Gloor et al., 1977 Quesney et al., 1977 AvoH et al., 1983 Steriade, 1990 Velasco et al., 1991). 

The respiratory system is responsible for generating and regulating the transpulmonary pressures needed to inflate and deflate the lung. Normal gas exchange between the lung and blood requires breathing patterns that ensure appropriate alveolar ventilation. Ventilatory disorders that alter alveolar ventilation are defined as hypoventilation or hyperventilation syndromes. Hyperventilation results in an increase in the partial pressure of arterial CO2 above normal limits and can lead to acidosis, pulmonary hypertension, congestive heart failure, headache, and disturbed sleep. Hypoventilation results in a decrease in the partial pressure of arterial CO2 below normal limits and can lead to alkalosis, syncope, epileptic attacks, reduced cardiac output, and muscle weakness. 

ECT is a much discussed procedure, partly because it has been perceived as a brutal medical treatment. It is performed under anesthesia, and because of the heavy muscle contractions, muscle relaxants are given. The shock elicits a seizure not very different from a grand mal epileptic attack the seizure is to last longer than 25 s. The effect is presumably from the enormous synchronized activity of the whole central nervous system. The treatment is usually repeated several times within a few weeks span. The treatment is often followed by a loss of memory for recent events, and the therapeutic effect is not permanent. 

Antagonism between folic acid and the anticonvulsants used in the treatment of epilepsy is part of their mechanism of action about 2% of the population have (drug-controlled) epilepsy. Relatively large supplements of folic acid (in excess of 1000 Jg/day) may antagonize the beneficial effects of the anticonvulsants and lead to an increase in the frequency of epileptic attacks. If enrichment of a food such as bread with folate is to provide 400 Jlg/day to those who eat little bread, those who eat a relatively large amount may well have an intake in excess of 1000 Jg/day. 

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