加利福尼亚大学旧金山分校讲座癫痫与发作总论与脑电图解读.pdf

Introduction to Clinical Neurology Seizures and Epilepsy Daniel Lowenstein, MD Andy Josephson, MD Wade Smith, MD, PhD Dan Lowenstein, MD • Robert B. and Ellinor Aird • Potential Conflicts of Professor of Neurology Interest • Director, UCSF Epilepsy - None Center • Department of Neurology, UCSF School of Medicine Learning Objectives Learning Objectives o Define seizure, epileptogenesis, and epilepsy. o Visualize the network properties of the cerebral cortex that give rise to the EEG. o Draw a diagram that depicts the basic mechanisms underlying an EEG “spike”. o Understand the classification system for seizures. o List at least two main causes of seizures in different age groups. o Specify the routine lab studies for the pt. with a 1st-time seizure and what results of these studies will tell you. o Describe the main factors in deciding whether or not to treat a 1st-time seizure. Learning Objectives (con’t ) o Describe some of the major molecular mechanisms of action of AEDs; include one or two drugs that work by each mechanism. o Describe two drugs considered as first-line therapy for generalized seizures and two for focal seizures (and familiarize yourself with main pharmacokinetic features and adverse effects). o Describe general principles of therapy of epilepsy with respect to starting and stopping drug therapy, switching from one drug to another, and using more than one drug. Define what is meant by “therapeutic” serum levels of AEDs. o Describe the characteristics of patients with medically refractory epilepsy who may benefit from surgical intervention. What I will not cover! o Lots of the details about pathophysiology o Details about epilepsy sy