Transcript Особливості перебігу та виходу астенічн

Ternopil State Medical
University
named I.Horbachevsky
Chair of neurology, psychiatry,
narcology and medical psychology
Prep. by Roksolana Hnatyuk
M.D., Ph.D.
EPILEPSY
Epilepsy
term for number of disorders characterized
by various combinations of the following:
periodic sensory or motor seizures (or
epileptic equivalent) accompaned by an
abnormal encephalogram (EEG), wich or
with actual convulsions, clouding of or loss
of consciousness, and motor, sensory or
cognitive malfunctions
Age group by % all first seizures occurring
in each age group
AGE
First seizures occurring
(%)
0-9
10-19
20-29
30-39
40+
47
30
13
6
4
Aura – a subjective
experience that
frequenty precede an
epileptic seizer. The aura
may occur any time
from a few hours to
several seconds prior to
onset.
Psychic Auras
 Type: Dysphasic (a)
 Symptoms: Nonfluent
 Probable Source: Left perisylvian
language areas
(a) Does not include speech arrest or simple
vocalizations.
Psychic Auras (continuance)
 Type: Dysmnesic
 Symptoms: Déjà vu, déjà vécu, déjà pensé,
déjà entendu, jamais vu, etc., prescience,
illusion of memory (b)
 Probable Source: Mesobasal temporal, b
especially on right
(b) Includes hippocampus, amygdala, and the
parahippocampal gyrus.
Psychic Auras (continuance)
 Type: Cognitive
 Symptoms: Dreamy state, altered time
sense, derealization, depersonalization
 Probable Source: Mesobasal temporal and
temporal neocortex
 Type: Cognitive
 Symptoms: Forced thinking, forced actions,
and altered or obscure thoughts
 Probable Source: Frontal association
cortex
Psychic Auras (continuance)
 Type: Affective
 Symptoms: Fear, anxiety,
apprehension, depression, pleasure,
displeasure
 Probable Source: Mesobasal temporal
and temporal neocortex
Psychic Auras (continuance)
 Type: Illusions (c)
 Symptoms: Macropsia, micropsia,
teleopsia, movement, metamorphopsia,
increased color intensity, increased
stereopsis intensity
 Probable Source: Lateral superior
temporal neocortex, especially on right for
visual illusions
(c) Includes interpretive (size, motion, shape, and
stereopsis) or experiential (elements of past experience
or involvement).
Psychic Auras (continuance)
 Type: Hallucinations (c)
 Symptoms: Structured, hallucinatory
remembrances, autoscopy
 Probable Source: Mesobasal temporal
and temporal neocortex
c Includes interpretive (size, motion, shape,
and stereopsis) or experiential (elements
of past experience or involvement).
Table 2 International Classification of
Epileptic Seizures
 Partial (focal, local) seizures
 Simple partial seizures
 Motor, somatosensory, autonomic, or
psychic symptoms
 Complex partial seizures
 Begin with symptoms of simple partial
seizure but progress to impairment of
consciousness
Table 2 International Classification of
Epileptic Seizures (continue)

Begin with impairment of
consciousness
 Partial seizures with secondary
generalization
 Begin with simple partial seizure
Table 2 International Classification of
Epileptic Seizures (continue)
 Begin with complex partial seizure
(including those with symptoms of
simple partial seizures at onset)
 Generalized seizures (convulsive or
nonconvulsive)
 Absence (typical and atypical)
Table 2 International Classification of
Epileptic Seizures (continue)

Myoclonus
 Clonic
 Tonic
 Tonic-clonic
 Atonic/akinetic
 Unclassified
Partial (focal, local) seizures
Partial (focal, local) seizures
Partial (focal, local) seizures
Generalized seizures
Generalized seizures
Generalized seizures
Anticonvulsant
 Carbamazepine (Tegretol)
 Phenytoin (Dilantin)
 Phenobarbital (Barbita) and primidone
(Myidone)
 Valproic acid (Depakene)
 Ethosuximide (Zarontin)
Anticonvulsant
 Clonazepam (Klonopin)
 Gabapentin (Neurontin)
 Lamotrigine (Lamictal)
 Vigabatrin (Sabril)
 Tiagabine (Gabitril)
Thank you for your attention!