Question

what is is Epilepsy? Have you had any experience with seizures? What is the difference between a febrile and afebrile seizure? Lastly, what are the differences between the first and second generation Anticonvulsants and list two examples of each.

Answer 1

Ans) Epilepsy is a condition in which a person has recurrent seizures. If all areas of the brain are affected by the abnormal electrical activity, a generalized seizure may result. This means that consciousness is lost or impaired.

- Seizures can take on many different forms, and seizures affect different people in different ways.
Not all parts of a seizure may be visible or easy to separate from each other. Every person with seizures will not have every stage or symptom.
An aura or warning is the first symptom of a seizure and is considered part of the seizure. Not everyone has an aura.
The middle of a seizure is often called the ictal phase. This correlates with the electrical seizure activity in the brain.
As the seizure ends, the postictal phase occurs - this is the recovery period after the seizure. Some people recover immediately while others may take minutes to hours to feel like their usual self.

- A febrile seizure is a convulsion in a child caused by a spike in body temperature, often from an infection. They occur in young children with normal development without a history of neurologic symptoms. It can be frightening when your child has a febrile seizure, and the few minutes it lasts can seem like an eternity.

Afebrile Febrile Seizures (AFS)- This disorder refers to children who have provoked seizures lacking objective evidence of fever at the seizure onset but have definitive symptoms and signs of minor infection. The presenting illness is usually a mild respiratory or gastrointestinal infection.

- The use of first-generation AEDs for epilepsy treatment decreased while second-generation drugs (e.g., levetiracetam and lamotrigine) increased. The higher cost of second-generation AEDs compared with first-generation drugs is a major reason for their restriction from formularies. Data show that second generation AEDs have lower risk of teratogenesis and a more favorable side-effect profile compared with first-generation drugs. While the risks of brand to generic substitution of AEDs are still unclear, generic versions of second generation AEDs are far more affordable as compared to brand name drugs. The strengthens the argument for easy availability of good quality, low-cost, generic versions of second-generation AEDs so that pregnant women without insurance and even those residing in low and middle income countries can benefit.

- The first-generation AEDs known to cause birth defects and other developmental toxicities include the hydantoins (ethotoin [Peganone], fosphenytoin [Cerebyx], mephenytoin [Mesantoin], and phenytoin [Dilantin]), phenobarbital, primidone (Mysoline), carbamazepine (Tegretol), and valproic acid derivatives (Depakene).

- Second generation include felbamate (Felbatol), gabapentin (Neurontin), lamotrigine (Lamictal), levetiracetam (Keppra), oxcarbazepine (Trileptal), tiagabine (Gabitril), topiramate (Topamax), and zonisamide (Zonegran).