Pharmacology 2060A/B Lecture Notes - Lecture 14: Clonus, Calcium Channel Blocker, Temporal Lobe

• School: Western University
• Department: Pharmacology
• Course: Pharmacology 2060A/B
• Professor: Andrea Di Sebastiano

Document Summary

14. 8% %epilepsy: epilepsy!is!a!neurological!disorder!that! produces!brief!disturbances!in!the!normal! electrical!activity!in!the!brain, epilepsy!is!characterized!by!sudden,!brief! seizures,!the!nature!and!intensity!of!which! vary!from!person!to!person. Focal/partial%seizures: these!seizures!arise!in!one!area!of!the! brain, the!terms!focal!seizure!and!partial! seizure!are!interchangeable, there!are!two!types!of!focal/partial! seizures:, simple!partial!seizure, complex!partial!seizure, simple!partial!seizure! Example!case: 45!year!old!man, clonic!movements!of!his!right! arm, progression!to!right!face!then! right!leg, no!impairment!of!consciousness, lasting!~!45!seconds, mri! !l!motor!strip! oligodendroglioma! Example!case:: 37!yearcold!man!with!right!temporal!lobe!epilepsy, whistling;!bicycling!movements!in!left!leg, rising!epigastric!sensation!with!nausea, normal!ictal!speech, no!memory!of!the!events!postcictally!(i. e. !after!seizure), duration:!30! !45!seconds. Generalized%seizure: these!seizures!have!a!bilateral,! diffuse!onset,!seeming!to!arise!from! all!areas!of!the!brain!at!once, there!are!5!different!types!of! generalized!seizures:, absence!seizures, tonic/clonic!seizures, myoclonic!seizures, tonic!seizures, atonic!seizures! Involve!loss!of!consciousness,!behavioural!arrest! and!staring: are!usually!brief!but!may!occur!in!clusters!and!can! recur!multiple!times!in!a!day, rarely!associated!with!automatisms! (unusual! purposeless!movements),!usually!minor!if!there! are!any, more!common!in!childhood. Tonic/clonic!seizures: tonic!clonic!seizures!involve:, an!abrupt!loss!of!consciousness, a!tonic!period! (muscles!become!rigid),!lasting!~!1!minute, a!clonic!period! (involuntary!muscle!contractions),!lasting!and! additional!2c3!minutes, patients!may!become!incontinent!and!have!tongue!biting. Myoclonic!seizures: these!seizures!involve!sudden,!brief!muscle!contractions!that!can!involve! any!muscle!group, usually!there!is!no!loss!of!consciousness, sometimes!they!are!associated!with!a!later!development!of!generalized!tonicc clonic!seizures, tonic!seizures, often!involve!sudden!muscle!stiffening!(rigidity), often!involve!impaired!consciousness, atonic!seizures! Involve!sudden!loss!of!muscle!tone: usually!brief,!around!15!seconds, also!known!as! drop!seizures ,!as!patients!typically!drop!to!the!ground, potential!for!falling!injuries, a!seizure!that!begins!in!one!area!of! the!brain! (like!a!focal!seizure)!and! then!spreads!throughout!the!brain, the!preliminary!focal!phase!is! sometimes!referred!to!as!an! aura . !! !frontal!lobe: simple!repetitive!motor!movements! involving!a!localized!muscle!group!are! associated!with!seizure!activity!in!the! contralateral! (opposite!side!of!the! brain)!primary"motor"cortex, tonic!posturing!affecting!the!entire!side! of!the!body!are!associated!with!seizure! activity!in!the!contralateral! Supplemental"motor"area! (sma)!and! other!higher!level!motor!structures. : very!complex!behavioural!automatisms! that!involve!bilateral!movement!such!as! swimming!or!bicycle!riding!movements! are!associated!with!seizure!activity!in!higher"areas"of"the"frontal"cortex. Temporal!lobe: emotions!such!as!anger,!fear,! euphoria!and!psychic!symptoms! such!as!d j !vu,!jamais!vu!or! amnesia!are!associated!with! seizure!activity!in!the!temporal! lobe, auditory! (hearing)! hallucinations!of!buzzing!or! voices!talking,!and!olfactory! (smell)!and!gustatory! (taste)! hallucinations!are!associated! with!the!temporal!lobe, more!complex!sensory! phenomena,!involving!visual! distortions,!paresthesias!(i. e. numbness)!and!autonomic!disturbances!can!also!be!associated!with!temporal! lobe!seizures. !parietal!lobe: localized!paresthesias,!such!as! numbness!and! pins!and!needles ,! are!associated!with!seizure!activity! in!the!contralateral!somatosensory" cortex, more!complex!and!widespread! paresthesias!are!associated!with! seizure!activity!in!the!somatosensory" association"cortex, seizure!activity!in!the!higher"order" sensory"association"areas!in!the! parietal!lobe!can!be!associated!with! complex!multicsensory! hallucinations!and!illusions. !the!hallucinations! are!less!likely!to!be!of!organized! objects!such!as!people!or!faces: seizure!activity!in!the!occipital! lobe!can!also!produce!temporary! blindness!or!decreased!vision,!as! well!as!the!sensation!of!eye! movement. !