Drugs Used in Epileptic Disorders

                                                                                         

You may have witnessed a typical roadside scene where a person has suddenly fallen down and people have gathered around him, saying that he has had an attack of mirgi (the Hindi name for epilepsy). Epilepsy is characterized by fits with loss or disturbance of consciousness, leading to an inability to maintain posture. There may be other symptoms like increased muscle tone causing a 'locked jaw', followed by decreased muscle tone, frothing at the mouth, and the eyeballs moving upwards followed by convulsive movements of the arms or legs. An attack of epilepsy may occur at any time and it is usually difficult to predict its onset. However, epilepsy attacks in which some patients get a warning signal or aura in the form of flashes of light or sounds is called major epilepsy (or grand mal epilepsy or generalised tonic-clonic seizures). Other forms are absence seizures (minor epilepsy or petit mal epilepsy); atonic seizures (akinetic unconsciousness with muscle relaxation resulting in fall); myclonic epilepsy (shock like intermittent muscular contractions) and infantile spasms (seen in infants).

Myoclonic epilepsy is characterized by jerky movements of some body parts alongwith tonic-clonic movements. Drugs like sodium valproate or clonazepam are found to be useful in the treatment of this form of epilepsy. Lamotrogine and topiramate are other durgs found to be useful.

Atonic epilepsy (seizures) is a variant of petit mal epilepsy in children. There is a history of repeated falls due to sudden loss of muscle tone. It is treated by drugs used in petit mal epilepsy.

Infantile spasms begins from infancy. There are brief jerking movements of whole body as a result there is spasm of whole body. It is associated with mental retardation. The treatment is unsatisfactory with drugs. Sodium valproate, clonazepam corticosteroids and are found to be effective in some cases.

Causes: The exact cause of primary epilepsy is not known. It has been suggested that some localized areas of the brain become hyperexcitable either due to changes in its vascular supply or other unknown reasons. Various factors such as changes in the blood gases, decrease in blood sugar and calcium, stress and strain, may precipitate an attack of epilepsy too. Seizures maybe due to brain infection, metabolic disturbances, toxic effect of drugs, withdrawal after longer use of alcohol and tranquilizers, eclampsia or brain tumors. Head-injury is another common cause.

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