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Pathogenesis - usually idiopathic
- other causes
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Generalized seizures - tonic-clonic (grand mal) -
myoclonic - tonic - atonic
- absence (petit mal) - infantile
- atypical absence spasms
Classification of seizures
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Differential diagnosis:-Syncope
-Vertigo-Tics
-Psychogenic symptoms -Breath holding spells
-Reflux in infants
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Plan/Management-Status epilepticus requires
transport to ED-Refer to neurologist for accurate
classification of seizure type-Monotherapy over polytherapy
-Monitor CBC, LFTs, drug levels-Treatment for 2 years (seizure
free)
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Partial seizures•Oxcarbazepine•Carbamazepine•Phenytoin•Phenobarbital•Levetiracetam•Lamotrigine•Topiramate
Absence seizures•Ethosuximide•Valproic acid
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Tonic-Clinic Seizures
•Phenytoin•Valproic acid•Carbamazepine•Topiramate•Levetiracetam
Myoclonic and Atonic Seizures
•Clonazepam•Lamotrigine - Levetiracetam
Infantile Spasms-ACTH-Topamax
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Used for seizures longer than 5 minutes in length or for clusters of
seizures
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Goal of pharmacologic treatment: seizure control
without adverse effects