Seizure secondarily generalized

Neurogenesis has been demonstrated in rodents, triggered by stimuli such as brief seizures. Secondarily generalized kindled seizures result in two- to threefold... 

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. 

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. 

C. Secondarily generalized (partial onset evolving to generalized tonic-clonic seizures)... 

GTC seizures may be preceded by premonitory symptoms (i.e., an aura). A tonic-clonic seizure that is preceded by an aura is likely a partial seizure that is secondarily generalized. Tonic-clonic seizures begin with a short tonic contraction of muscles followed by a period of rigidity. The patient may lose sphincter control, bite the tongue, or become cyanotic. The episode may be followed by unconsciousness, and frequently the patient goes into a deep sleep. 

Vigabatrin is a new antiepileptic for use in epilepsy unresponsive to other therapy. It is an irreversible inhibitor of GABA-transaminase, the enzyme responsible for inactivation of the neurotransmitter GABA and it has shown efficacy against partial and secondarily generalized seizures. The principal unwanted effects are psychiatric disorders, including depression and psychosis, in a small number of patients. 

Felbamate, a new anticonvulsant, has beneficial effects in partial and secondarily generalized seizures.lt can reduce symptoms in Lennox-Gastaut syndrome. However an association with aplastic anemia reduces its usefulness and Lennox-Gastaut syndrome is considered to be its only indication. 

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. 

The last type of partial seizure is the secondarily generalized attack, in which a partial seizure immediately precedes a generalized tonic-clonic (grand mal) seizure. This seizure type is described in the text that follows. 

In partial seizures only part of the brain (i.e., one cerebral hemisphere) is involved, whereas in generalized seizures the whole brain is involved. Partial seizures that spread throughout the entire brain are referred to as partial becoming generalized or secondarily generalized seizures. 

Partial seizures account for the majority of refractory convulsant disorders in adults, often requiring more than one drug to achieve adequate therapeutic control. Three new compounds with unique mechanisms of action have been approved for use in partial seizures and, secondarily, generalized seizures. Figure 15.9 summarizes some therapeutic advantages and disadvantages of selected antiepileptic drugs. 

A 41-year-old woman with a long-standing history of focal and secondarily generalized seizures controlled... 

Generalized seizures have clinical manifestations that indicate involvement of both hemispheres. Motor manifestations are bilateral, and there is a loss of consciousness. Generalized seizures may be further subdivided by EEG and clinical manifestations. A partial seizure that becomes generalized is referred to as a secondarily generalized seizure. 

Partial seizure—A seizure that begins in one hemisphere of the brain. It may be simple, complex, or secondarily generalized. 

An active controlled, randomized, double-blind protocol demonstrated the efficacy of felbamate in patients with poorly control partial and secondarily generalized seizures. Felbamate also was found to be efficacious against seizures in patients with Lennox-Gastaut syndrome. The clinical efficacy of this compound, which inhibited responses to NMDA and potentiated those to GABA, underscores the potential value of additional antiseizure agents with similar mechanisms of action. 

Lamotrigine is useful for monotherapy and add-on therapy of partial and secondarily generalized tonic-clonic seizures in adults and Lennox-Gastaut syndrome in both children and adults. Lennox-Gastaut syndrome is a disorder of childhood characterized by multiple seizure types, mental retardation, and refractoriness to antiseizure medication. 

Tonic-clonic seizure As described above for partial with secondarily generalized tonic-clonic seizures except that it is not preceded by a partial seizure. Carbamazepine, phenobarbital, phenytoin, primidone, valproate Lamotrigine, topiramate... 

PHARMACOLOGICAL EFFECTS AND MECHANISM OF ACTION Levetiracetam exhibits clinical effectiveness against partial and secondarily generalized tonic-clonic seizures. The mechanism by which levetiracetam exerts these antiseizure effects is unknown. 

SIMPLE AND COMPLEX PARTIAL AND SECONDARILY GENERALIZED TONIC-CLONIC SEIZURES... 

C. Partial seizures evolving to secondarily generalized tonic-clonic convulsions Generalized seizures (convulsive or nonconvulsive)... 

Partial Seizures Evolving to Secondarily Generalized Seizures... 

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