Epilepsy an overview

Recent Advancements in Epilepsy ,[object Object],[object Object],[object Object],[object Object]

Introduction ,[object Object],[object Object]

Historical Background ,[object Object],[object Object],[object Object]

Historical Background contd ,[object Object],[object Object]

Historical Background contd ,[object Object],[object Object],[object Object]

Historical Background contd ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Epilepsy synonyms in South East Asia ,[object Object],[object Object],[object Object],[object Object],[object Object]

Epidemiology of Epilepsy ,[object Object],[object Object],[object Object],[object Object],[object Object]

Prevalence in South East Asian Countries ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Classification of Seizures ILAE Classification (1981) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Causes of Epilepsy ,[object Object],[object Object],[object Object],[object Object]

Drugs That Induce Seizures ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Drugs That Induce Seizures ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Pathophysiology of Epilepsy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Pathophysiology of Epilepsy contd ,[object Object],[object Object],[object Object]

Clinical Presentations ( Partial Seizures) ,[object Object]

Clinical Presentations ,[object Object],Clinical Presentations ( Partial Seizures)

Clinical Presentations (Partial Seizures) ,[object Object],[object Object]

Clinical Presentations (Complex Partial Seizures) ,[object Object]

Clinical Presentations (Generalized Seizures) ,[object Object]

Generalized Tonic-clonic (grand mal) ,[object Object]

Clinical Presentations (Generalized Seizures) ,[object Object],[object Object],[object Object],[object Object]

Clinical Presentations Typical Absence Seizures (Petit mal)

Clinical Presentations ,[object Object],[object Object],[object Object],[object Object],[object Object]

Clinical Presentations ,[object Object],[object Object],[object Object],[object Object]

Diagnosis of Epilepsy ,[object Object],[object Object],[object Object],[object Object],[object Object]

Differential Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],No Change (may worsen) Suppress seizures Anti Epileptic drug usage No change Raised Serum prolactin (after attack) No Change Slowing pattern EEG after attack No Change Abnormal EEG during attack Yes No Can be precipitated by suggestion No Yes Occurs during sleep No Yes Injury Absent Present Post-Ictal Phenomena Long Short Duration No Yes Tongue bite No Yes Resemble known seizure types Pseudoseizure True Seizure Features & Lab findings

Management of Epilepsy ,[object Object],[object Object],[object Object],[object Object],[object Object]

Guidelines for Anticonvulsant Therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Choice of Anti Epileptic Drugs Piracetam Lamotrigine Phenobarbital Clonazepum S. Valporate Myoclonic Clonazepum Acetazolamide Ethosuximide S. Valporate Lamotrigine Absence Phynytoin Gabapentin Phenobarbital Tiagabine Acetazolamide Lamotrigine Topiramate Carbamazepine S. Valporate Primary GTCS Clobazum Phynytoin Phenobarbital Vigabatrin Acetazolamide S. Valporate Tiagabine Gabapentin Carbamazepine Lamotrigine Oxcarbazepine Topiramate S. Valporate (in children) Partial and /or Secondary GTCS Third-Line Second-Line First-Line Epilepsy Type

AED: Indications and Dosage NA 1-2 25-500 Partial, secondary GTCS Lamotrigine NA -- 4 i.v. Status Epilepticus Lorazepum 200-700 2 500-1500 Childhood Abssence Ethosuximide NA 1-2 200-600 Partial, secondary GTCS Topiramate NA 2-4 1-8 Partial (adjunctive), Myoclonus Clonazepum 50-150 1 60-100 Partial, secondary GTCS Phenobarbital 40-80 1 150-350 Partial, Secondary GTCS Phenytoin NA 1-2 400-2500 Primary & Secondary GTCS, Absence, Myoclonus Sodium Valporate 30-50 2-3 250-2000 Partial,Secondary GTCS, Carbamazepine Therapeutic range ( μmol/L) Doses per day Dose range (mg/day) Seizure type AED

AED: Side Effects SLE Facial Dysmorphism Foliate deficiency Nausea, depression, Taste alteration, Weight loss Foliate deficiency, Depression (adults), Excitement (Children), SLE Hyponatremia Nausea, Weight Gain Others Other AEDs, OCP Nephro- -lithiasis ---- ---- ---- Confusion Drowsiness Ataxia Topiramate Side Effects  Other AEDs, OCP, Anti Arrythmic, Antimalarials, Corticosteroids Thyroxine Other AEDs, CCB,OCP, Digoxin, Antidepressant, Antimalarials Other AEDs, OCP, Antimalarials, Corticosteroids Other AEDs, Antimalarials Drug Interactions Liver damage ---- ---- Liver damage Hepatology & Kidney ---- ---- ---- Pancreatitis Endocrine Blood dyscrasias Osteomalacia Megalobastic Anaemia, Osteomalacia Blood Dyscrasias, Thrombo- -cytopenia Blood dyscrasias Hematological Rashes, Hirsutism, Gum Hypertrophy, Rashes Rashes, SJS, Rashes, Alopecia Dermatological Drowsiness Drowsiness Drowsiness Drowsiness Cognitive & behavioral Ataxia, Nystagmus, Diplopia, Tremor, Dystonia, Asterixis Neuropathy Ataxia, Nystagmus, Diplopia Neuropathy Ataxia, Nystagmus, Diplopia Ataxia, Nystagmus, Diplopia, Tremor Neurological Phenytoin Phenobarbital Carbamazepine Sodium Valporate AED 

Withdrawal of AED ,[object Object],[object Object],[object Object],[object Object]

Prognosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Psychiatric comorbidities in Epilepsy ,[object Object],[object Object],[object Object],[object Object],[object Object]

Recent Research and Achievements ,[object Object],[object Object],[object Object],[object Object]

Recent Research and Achievements ,[object Object],[object Object]

Famous Persons with Epilepsy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Acknowledgements ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Epilepsy an overview

Epilepsy an overview

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Epilepsy an overview