Pathogenesis - usually idiopathic

- other causes

Generalized seizures - tonic-clonic (grand mal) -

myoclonic - tonic - atonic

- absence (petit mal) - infantile

- atypical absence spasms

Classification of seizures

Differential diagnosis:-Syncope

-Vertigo-Tics

-Psychogenic symptoms -Breath holding spells

-Reflux in infants

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)

Partial seizures•Oxcarbazepine•Carbamazepine•Phenytoin•Phenobarbital•Levetiracetam•Lamotrigine•Topiramate

Absence seizures•Ethosuximide•Valproic acid

Tonic-Clinic Seizures

•Phenytoin•Valproic acid•Carbamazepine•Topiramate•Levetiracetam

Myoclonic and Atonic Seizures

•Clonazepam•Lamotrigine - Levetiracetam

Infantile Spasms-ACTH-Topamax

Used for seizures longer than 5 minutes in length or for clusters of

seizures

Goal of pharmacologic treatment: seizure control

without adverse effects