Considerations for Epilepsy Treatment in Pediatrics

Age Insurance Comorbidities (particularly ADHD, cerebral palsy, autism, mental retardation, migraines and being conscious of the drug-drug interactions that may be associated with the meds being used to treat those conditions) Correct diagnosis of seizure disorder (seizure type and EEG findings if applicable) Side effect profile of antiepileptic Medication administration considerations (ex. tabs vs. liquids; … Continue reading

Epilepsy Resources

http://www.ilae-epilepsy.org http://www.aan.com http://www.epilepsyfoundation.org

Symptoms of Schizophrenia

Atypical antipsychotics block both dopamine-2 receptors and serotonin-2A receptors Symptoms of schizophrenia: Positive symptoms: the presence of symptoms that are normally absent Examples of positive symptoms include: hallucinations, disorganized speech, delusions, memory disturbances, and impaired attention. Positive symptoms associated with schizophrenia are improved by blocking dopamine-2 receptors. Negative symptoms: the absence of thoughts or behaviors … Continue reading

Multiple Sclerosis

Slightly more common in women than men, more often in whites than other races, most commonly first diagnosed in ppl between 20-40 years old Appears to be a genetic factor Autoimmune disease that causes the body to produce antibodies against myelin.  Demyelination of nerves causes impulses to travel more slowly & lead to decreased coordination … Continue reading

ADHD

Evidence suggests a genetic link Altered neurotransmitters in the CNS may cause decreased executive functioning ADHD & School/Work:  poorer performance, more disruptive, more frequently lose/change jobs ADHD & Life skills:  have fewer friends, more divorces/broken relationships, more teen pregnancies, more car accidents Diagnosis:  6 or more symptoms of inattention or hyperactivity/impulsivity for at least 6 … Continue reading

Anxiety

Anxiety ~15% of people are affected (only 1/3 that suffer seek treatment–not curative in most cases but can decrease symptoms and increase quality of life) Life events can be the cause (anxiety is usually self-limiting if the event was acute) Commonly occurs concomitantly with other psych disorders especially depression Generalize anxiety disorder (GAD) Most common … Continue reading

Status Epilepticus

Status epilepticus = any seizure lasting longer than 30 minutes or the presence of recurrent seizures (either clinical or electrical) w/o a seizure free period in between Frequently cognitive decline is seen following the incident MOA:  GABA system loses its ability to inhibit seizure activity  (however GABA levels may be elevated during status epilepticus) Can … Continue reading

Epilepsy

Seizure:  brief, episodic neuronal discharge which causes changes in consciousness, movement, senses &/or behavior Abnormal firing of neurons & a breakdown of normal inhibition (either at one spot in the brain or over the entire brain) Seizures beget seizures–increase in frequency & new seizure types Convulsion:  series of violent muscle contractions All convulsions are seizures … Continue reading

Migraine Headache

Migraine Headache Most common in women by the age of 35 Believed to be a neurovascular HA We use prophylactic agents (vasodilators like BBs) to prevent constriction but for acute attacks we use vasoconstrictors (like triptans) to dilate other arteries in the scalp & neck Migraine Symptoms: Prodrome:  indicates a migraine is imminent.  May be … Continue reading

Tension Headache

Tension Headache Most common type of HA More common in women usually by age 20 Acute more common than chronic Pain originates from myofascial tissues, exacerbated by physical/mental stress Symptoms:  pain is mild-moderate, band-like, dull, non-pulsating & bilateral               often coexists with depression Muscle tension is common:  patients have difficulty relaxing on command, have restless movements … Continue reading