Tonic-clonic seizures, generalised

Phenobarbitone may be as effective as phenytoin and carbamazepine in partial and generalised tonic-clonic seizures but its other central effects such as sedation, depression, listlessness and cognitive impairment mar its usefulness. 

Largactil is a proprietary preparation of chlorpromazine, an aliphatic antipsychotic with marked sedation and moderate antimuscarinic and extrapyramidal side-effects. Serenace is a proprietary preparation of haloperidol, a butyrophenone antipsychotic with marked extrapyramidal side-effects, moderate sedation but not very likely to cause hypotension. Tegretol is a proprietary preparation of carbamazepine, an anti-epileptic drug indicated in partial and secondary generalised tonic-clonic seizures, primary generalised tonic-clonic seizures, trigeminal neuralgia and in the prophylaxis of bipolar disorder unresponsive to lithium. 

I The aim of ECT is to induce safely a generalised tonic-clonic seizure lasting at least 25 seconds. 

A generalised tonic-clonic seizure occurred in a 42-year-old woman immediately after she was anaesthetised with 120 mg of intravenous methohexital for the last in a series of six electroconvulsive therapies. She had been receiving paroxetine 40 mg daily throughout the series. The au-... 

Sodium valproate Phenytoin Cisplatin Etoposide Bleomycin Testicular cancer Serum valproate levels reduced by 50% after the first cycle and generalised tonic-clonic seizures occurred. There was no effect on phenytoin levels. 13... 

An isolated report deseribes a 20-year-old woman, with a 7-year history of epilepsy (bilateral myoelonus and generalised tonic-clonic seizures) controlled with sodium valproate 1.3 g daily, who developed tonic-clonic seizures 8 hours after taking the second of 3 prophylactic doses of mefloquine 250 mg. It is not clear whether this resulted from a drug-drug or a drug-disease interaction. The manufacturers of mefloquine advise its avoidance in those with a history of convulsions as it may increase the risk of convulsions. In these patients mefloquine should he used only for curative treatment if compelling reasons exist. ... 

A patient with non-Hodgkin s lymphoma experieneed a syncopal episode with generalised tonic-clonic seizures 8 days after eompleting an initial 5-day course of treatment with chlorambucil 12 mg daily and prednisone 50 mg daily. The seizures were controlled with intravenous clonazepam. Four weeks later, on the third day of a second course, she again had generalised tonic-clonic seizures, which resolved spontaneously. 

Nervous System CNS toxicity including generalised tonic-clonic seizures due to the EMLA cream was reported in a 4-month-old female with vascular malformations who was treated with 60 g EMLA cream prior to laser treatment [42 ]. The authors note that the patient s vascular malformation may have increased the absorption of the topical medication. 

Nervous system A 50-year-old woman with metastatic colon cancer presented with refractory generalised tonic-clonic seizures 3 weeks posttreatment with FOLFIRI and bevacizumab. The patient became seizure-free on antiepileptic therapy of levetiracetam and phenytoin but lost consciousness, became hypotensive and died following cardiac arrest. Reversible posterior leucoencephalopathy syndrome did not accord with the patient s clinical picture and it is speculated that the mechanism of the promotion pf seizures by bevacizumab in this case may have been due to blood-brain barrier damage [99 ]. 

Various animals show spontaneous epilepsy or seizures that can be readily induced by sensory stimulation (see Jobe et al. 1991). Tottering mice display seizures that resemble absence attacks behaviourally, in their EEG pattern and response to drugs. DBA/2 mice show reflex seizures to audiogenic stimuli while photically-induced seizures can be obtained in the Senegalese baboon, Papiopapio, which are similar to generalised tonic-clonic epilepsy. 

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

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