Partial seizures complex

Benzodiazepines and barbiturates are used as anticonvulsant drugs in the treatment of epilepsy. Epilepsy, a medical disorder characterized by recurrent seizures, has many different forms. The four most common seizure types are generalized tonic-clonic seizures (old name grand mal seizures), generalized absence seizures (petit mal seizures), complex partial seizures (psychomotor or temporal lobe seizures), and simple partial seizures (focal seizures). 

It is mainly used as adjunctive therapy in patients for simple partial seizures, complex partial seizures, secondary generalised tonic and clonic seizures. 

It is one of the drugs of choice for the management of generalized tonic-clonic (grand mal) seizures, complex partial (temporal lobe psychomotor) seizures and simple partial (focal, Jacksonian) seizures. 

Locatelli ER, Varghese JP, Shuaih A, Potohcchio SJ. Cardiac asystole and bradycardia as a manifestation of left temporal lobe complex partial seizure. Ann Intern Med... 

Complex partial seizures manifest themselves as bizarre behaviours which are also known as psychomotor or temporal lobe epilepsy, since a lesion (focus) is often found in that brain area. Repetitive and apparently purposeful movements vary from simple hand clenching or rubbing to more bizarre hand movements and walking. These can last a few minutes, often disrupt other ongoing activity or speech and the patient has no subsequent memory of them. Complex seizures may develop from simple ones. 

Secondarily generalized Seizures that start as a simple or complex partial seizure and spread to involve the entire brain. Patients may report a warning or aura, and these are actually the start of the seizure. 

LJ, a 25-year-old-woman with complex partial seizures, presents a prescription to the pharmacy for a triphasic oral contraceptive containing ethinyl estradiol and norgestimate. A review of her medication profile shows that she is taking carbamazepine extended-release 1200 mg/day. Her last refill for this prescription was 2 weeks ago. She reports that she has not had a seizure for a year and that she just became engaged. She is planning to be married in 4 months. 

In most cases, the healthcare provider will not be in a position to witness a seizure. Many patients (particularly those with complex partial [CP] or GTC seizures) are amnestic to the actual seizure event. Obtaining an accurate history and description of the ictal event (including time course) from a third party is important. 

Partial (focal) seizures begin in one hemisphere of the brain and, unless they become secondarily generalized, result in an asymmetric seizure. Partial seizures manifest as alterations in motor functions, sensory or somatosensory symptoms, or automatisms. If there is no loss of consciousness, the seizures are called simple partial. If there is loss of consciousness, they are termed complex partial, and the patients may have automatisms, memory loss, or aberrations of behavior. 

Partial seizures with secondary generalization Simple partial Somatomotor Dysphasic Other types Complex partial Elementary Temporal lobe, psychomotor, epi-... 

Ben-Menachem, E., Soderfelt, B., Hamberger, A., Hedner, T., and Persson, L. I. (1995) Seizure frequency and CSF parameters in a double-blind placebo controlled trial of gabapentin in patients with intractable complex partial seizures. Epilepsy Res. 21,231-236. 

Epilepsy For use as sole and adjunctive therapy in the treatment of simple and complex absence seizures and adjunctively in patients with multiple seizure types that include absence seizures as monotherapy and adjunctive therapy in the treatment of patients with complex partial seizures that occur in isolation or in association with other types of seizures. 

Partial seizures Tonic-clonic Complex partial Absence Generalized seizures ... 

B. Complex partial seizures (psychomotor epilepsy, temporal lobe epilepsy)... 

Unlabeled Uses Adjunctive treatment of seizures treatment of simple, complex partial, and tonic-clonic seizures... 

A child with attention-deficit hyperactivity disorder [ADHD] and conduct disorder is treated with 45 mg/d of methylphenidate and 2 mg/d of risperidone. A new diagnosis of complex partial seizures is made and the child is started on carbamazepine. About 10 days after the initiation of carbamazepine, the child develops withdrawal dyskinesias of mouth and tongue. After discontinuation of carbamazepine, the movements last for 1 week. 

The safety and efficacy of gabapentin as adjunctive therapy to CBZ and/or phenytoin has been assessed in adults, adolescents (Bruni, 1998), and children (Khur-ana et ah, 1996) with partial seizures. A decrease of 50% or more in frequency of complex partial -I- secondary generalized seizures was reported in 71% of patients on a mean maintenance dose of gabapentin of 1600 mg/day (Bruni, 1998). It has also been used in the treatment of spasticity in adolescents with multiple sclerosis (Cutter et al., 2000) and in adults and adolescents with neuropathic pain (Rosenberg et al.,... 

Mattson, R.H., Ctamer, J.A., and Collins, J.F. (1992) A comparison of valproate with carbamazepine for the treatment of complex partial seizures and secondarily generalized tonic-clonic seizures in adults. The Department of Veterans Affairs Epilepsy Cooperative Study No. 264 Group [see comments]. N Engl J Med 327 765-771. 

Barak Y, Levine J, Behnaker RH Effects of inositol on lithium induced EEG abnormalities. Eur Neuropsychopharmacol 4 419-420, 1994 Barczak P, Edmunds E, Betts T Hypomania following complex partial seizures. Br J Psychiatry 152 137-139, 1988... 

It is used as adjunctive treatment of seizures including refractory seizures, simple and complex partial seizures. 

Anxiety is characterized by fear and apprehension that may or may not be associated with a cieariy identifiabie stimuius. Anxiety is a common reaction to significant life stress, is seen in conjunction with almost every psychiatric disorder, and is a common component of numerous organic disorders as well (e.g., hyperthyroidism, hypoglycemia, pheochromocytoma, complex partial seizures, pulmonary disorders, acute myocardial infarction, caffeine intoxication, various substances of abuse). Anxiety is almost invariably accompanied by physical symptoms such as the following ... 

Sheard (257) investigated men in a maximum security prison who repeatedly committed aggressive acts but were not psychotic or brain-damaged. In this blinded study of lithium, he found that it reduced impulsivity and aggression. Without knowledge of an individual s psychopathology, however, it is difficult to know for whom lithium may be most useful, but his observation warrants further study. By contrast, Schiff (258) reported a case in which lithium exacerbated interictal aggression in patients with complex partial seizures. 

Primidone, like its metabolites, is effective against partial seizures and generalized tonic-clonic seizures and may be more effective than phenobarbital. It was previously considered to be the drug of choice for complex partial seizures, but later studies of partial seizures in adults... 

Clorazepate dipotassium is approved in the USA as an adjunct to treatment of complex partial seizures in adults. Drowsiness and lethargy are common adverse effects, but as long as the drug is increased gradually, dosages as high as 45 mg/d can be given. 

The absence (petit mal) seizure is characterized by both sudden onset and abrupt cessation. Its duration is usually less than 10 seconds and rarely more than 45 seconds. Consciousness is altered the attack may also be associated with mild clonic jerking of the eyelids or extremities, with postural tone changes, autonomic phenomena, and automatisms. The occurrence of automatisms can complicate the clinical differentiation from complex partial seizures in some patients. Absence attacks begin in childhood or adolescence and may occur up to hundreds of times a day. The electroencephalogram during the seizure shows a highly characteristic 2.5-3.5 Hz spike-and-wave pattern. Atypical absence patients have seizures... 

Control of generalized tonic-clonic (grand mal)and complex partial (psychomotor, temporal lobe) seizures... 

B. Complex partial seizures (needed to differentiate this from absence seizures) Consciousness impaired bizarre behavior wide variety of other manifestations specific electroencephalography (EEG) abnormality... 

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