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Final Paper-Seizures Seizure 1 A sudden attack spasm or convulsion as in epilepsy or another disorder 2 A sudden onset or sensation of feeling or emotion In this case we are talking about the kind of seizure associated with Impaired consciousness and awareness of surroundings This is called a Complex Partial Seizure In the US For people younger than 60 years the incidence of partial seizures is 20 per 100000 person-years For people aged 60-80 years incidence increases to 80 per 100000 person-years Prevalence of epilepsy is 05-1 per 100 persons Complex partial seizures occur in about 35 of persons with epilepsy Causes Possible causes of complex partial seizures include the following Brain trauma Encephalitis Meningitis Stroke Perinatal brain injuries Vascular malformations Cortical dysplasia Neoplasms Complex partial seizures in most patients represent a symptom of underlying temporal lobe epilepsy the cause of which is unknown Characteristic pathologic changes termed mesial temporal sclerosis are most often visible on brain MRI Medical Care Anticonvulsant therapy generally is indicated when patients have more than one seizure The goal is to make the patient seizure free Even one seizure per year may prevent the patient from working andor driving Monotherapy generally is considered to be preferable to therapy with 2 or more anticonvulsants Cognitive side effects are common with anticonvulsants The newer anticonvulsants gabapentin lamotrigine tiagabine and topiramate have the following characteristics Are more costly than older anticonvulsants Are excellent drugs to use when treatment with 2 anticonvulsants is needed because they have minimal hepatic drug interactions Do not require serum drug-concentration monitoring Have a high therapeutic index Are well tolerated and can be used at doses greater than the maximum recommended dose Although many anticonvulsants are listed as category D unsafe in pregnancy continuing to take anticonvulsants during pregnancy is usually safer for women who require these drugs for seizure control Phenytoin and valproate have the following characteristics Bind strongly to serum
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