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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
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