16-抗癫痫药

types of epilepsy
clinical features
anti-epileptic drugs (*preferred)
2.absence seizures
(petit mal)
patient abruptly ceases whatever he or she is doing, and stares vacantly for a few seconds, with unaware of surroundings;
carbamazepine*, phenytoin, valproate, phenobarbital, primidone, vigabatrin, lamotrigine, antiepilepsirine;
status epilepticus: diazepam* (i.v.);
Table 16-1 (3) Types of Epilepsy and Anti-epileptic Drugs
carbamazepine*, valproate, clonazepam, phenytoin, phenobarbital, primidone, antiepilepsirine, lamotrigine;
2. complex partial seizures (psychomotor epilepsy)
二、根据临床表现可分为局限性发作和全身性发作。
正常脑细胞
病灶 异常高频放电
Table 16-1 (1) Types of Epilepsy and Anti-epileptic Drugs
types of epilepsy
clinical features
partial seizures
anti-epileptic drugs (*preferred)
partial seizures is followed by tonic-clonic seizures without loss of consciousness, lasting for 1~2min;
the same drugs mentioned above;
generalized seizures
1. simple partial seizures
involuntary muscle contraction and abnormal sensory experience without loss of consciousness, seizures lasting for 20~60 sec;
than absence seizures; nitrazepam, clobazam;
H N
C
CO
C
N
O
H
phenytoin
H2
H 5C 2
C
C
CO
H3C C
N
H
O
H 5C 2
O NH
O
N H
O
phenobarbital
H 5C 2
O NH
O
N
H
primidone
N
O
NH2
CH3 CH3
CH2 CH2
ethosuximide*, clonazepam, valproate, nitrazepam, clobazam;
3. atypical absence seizures
This seizures occurs and ethosuximide*,
recovers more slowly
clonazepam, valproate,
Table 16-1 (2) Types of Epilepsy and Anti-epileptic Drugs
types of epilepsy
clinical features
anti-epileptic drugs (*preferred)
3. partial seizures with following tonicclonic seizures
Lennox-Gastaut综合征（变异小发作）
肌阵挛发作
（包括婴儿阵挛、儿童阵挛、青春期阵挛，部分肌群 短暂抽搐1s，EEG特有爆发性多棘波）
强直-阵挛发作（大发作） 癫痫持续状态
复合型局限发作（精神运 动性发作、颞叶癫痫）
（冲动性发作，有无意识的 运动，唇抽动、摇头、搓手 等，持续30s-2min）
Jackson癫痫（局限发作的 特例，开始表现为部分发 作后扩展至全身）
癫痫发作分类
全身性发作
失神发作（小发作）
(多见于儿童，短暂意识丧失，EEG为3HZ/s高幅对 称同步化棘波)
1. tonic-clonic seizures (grandmal) and status epilepticus
immediate loss of consciousness with generalized tonic-clonic convulsion, lasting for a few minutes. Seizures lasting for longer time is termed as status epilepticus;
CH2 CH COONa
CH2
ethosuximide carbamazepine valproate sodium
Fig. 16-1 Molecular structures of antiepileptic drugs
癫痫发异 常，持续20-60s)
第十六章 抗癫痫药 Anti-epileptic Agents
第一节 抗癫痫药物
一、癫痫
反复发作的神经系统疾病。其特征为大脑局部 病灶神经元突发性的异常高频放电并向周围组 织扩散，出现短暂的大脑功能失调幻灯片 3。表 现为突然发作性的短暂的运动、感觉、意识和 植物神经功能异常,可伴有脑电图改变。癫痫的 治疗应长期用药，以减少或防止发作，但不能 根治。
conscious disturbance and psychiatric symptom with often involuntary movement, such as shake head, lasting for 0.5~2min;
the same drugs mentioned above;