EPILEPSY ppt 03

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EPILEPSY : 

EPILEPSY Submitted by: Ashweeni kumar singh 2006V15B Submitted to: DR. Yudhbir singh

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EPILEPSY paroxysmal, self limited functional cerebral disturbances characterised by abnormal activity of brain leading to the overt sine known as “Seizure”, “fits” or “convulsion”. Each attack is characterised by sudden loss of consciousness. Classification According to aetiology (a)Idiopathic epilepsy (b)Symptomatic (secondary) epilepsy IDIOPATHIC- no structural brain lesions or other neurological signs. Genetic and age dependent.

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SYMPTOMATIC Local causes- Traumatic injury of cranium. Degenerative changes in cerebrum. Congenital malformation of brain. Space occupying lesions (cyst, tumor, abscess) Inflammation (meningitis, encephalitis). Otitis media. General causes- Metabolic disturbances Fever-febril convulsion, febril fit. Cardiac disorder Distemper, Cryptococcosis. Round worm infestation; Tapeworm infestation

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According to nature of Fit (Clinical) (A) General epilepsy (B) Focal epilepsy (A) GENERAL EPILEPSY- Abnormal electrical discharges spread all over the brain. These include 3 types (1) Grand mal or Major epilepsy (2) Petitmal or Minor epilepsy (3) Status epilepticus MAJOR EPILEPSY (GRAND MAL) Stage of aura Stage of prodrom (unconciousness) Stage of ictus (convulsion) Stage of post ictus (post convulsive)

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MINOR EPILEPSY (PETIT-MAL) - Very brief fit lasting from 10-30 seconds. - Rare condition in animal. -Blinking movement of eyes and jerking movement of head and legs. STATUS EPILEPTICUS -Multiple continuous seizures with either a brief or total lack of interictal period. -May produce irreversible damage of brain and death. - Death may be accentuated from hyperthermia, lactacidosis and shock. (B) FOCAL EPILEPSY- abnormal electrical discharge is localised to a particular part of brain. These may be (1) Temporal lobe epilepsy psychomotor epilepsy. (2)Jacksonian epilepsy. (3) Myoclonic epilepsy. (4) Akinetic attack or focal fits.

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Differential Diagnosis Causes within 6 months of age - Juvenile epilepsy - Inflammation induced epilepsy - Toxin induced epilepsy - Traumatic epilepsy - Hypoglycemic epilepsy - Hydrocephalus predisposed epilepsy - Hepatic encephalopathy induced epilepsy (B) Causes within 6 months to 5 years of age - Idiopathic - Infectious - Noninfectious - Tumours

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DIAGNOSIS - Based on history and clinical sign - Routine examination of blood, stool and urine - Blood biochemistry - Examination of CSF - X-Ray of skull - Electro encephalogram - MRI Scan (C) Causes in more than 5 years of age - Symtomatic - Inflammatory disease - Thalamocortical tumors - Encephalopathy - Beta cell tumor

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LINE OF TREATMENT GENERAL TREATMENT Constipation of bowel should be avoided. Animal should be kept in a safe place to avoid self-inflicting trauma or accidents MEDICAL TREATMENT Phenobarbitone or Dilantin sodium or primidon Sodium valproate Phenobarbitone. If it does not respond then add Dilantin sodium along with phenobarbitone. If these combinations fail then add primidon(Mysoline) and gradually withdraw barbitone. Sodium valproate or zarontine(Parke Davis) I.T.S.F. B.D. orally are recomended

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Some guidelines of therapy Maximum dose should be given initally. No drug should be withdrawn suddenly. Replacing of one drug by other should not be done overnight but be done gradually. The drug should be continued for few days after the last attack. More dose may be given in the evening rather than morning. ANTIEPILEPTIC DRUGS Potassium bromide 20 to 40 mg/kg daily Pheno barbital 2 to 5 mg/kg twice daily Diazepam 0.5 to 1 mg twice daily Clonazepam 0.5 to 2 mg per dog thrice daily DRUGS CONTRA INDICATED IN EPILEPSY- Phenothiazine derivative tranquilizers e.g.Chlorpromazine (Largactil), Triflupromazine (Siquil)

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THANKS

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