医学课件抗癫痫药_1.ppt

抗癫痫药 Antiepileptic Drugs 北京协和医学院基础医学院药理学系 叶菜英 Definitions in epilepsy: Epilepsy comprises recurrent episodes of abnormal cerebral neuronal discharge. The resulting seizures are usually clinically obvious and vary in pattern according to which parts of the brain are affected. Epilepsy can be caused by many neurological diseases, including infection, trauma, infarction and neoplasia. Heredity has an important role (especially in the idiopathic generalised epilepsies). Common seizure types of Epilepsy: Generalised seizures. Absence (petit mal). Tonic/clonic (grand mal). Partial seizures. Simple partial seizures. Complex partial seizures (temporal lobe epilepsy). Generalised seizures: Absence (petit mal): These seizures have abrupt onset and cessation, with impaired consciousness, but with normal posture often retained. The EEG shows a typical ‘spike and wave’ pattern. Tonic/clonic (grand mal): Consciousness is impaired and the patient usually falls to the floor. A phase of muscle contraction (‘tonic’) is followed by irregular muscle clonus and then by sleep. Injury may occur. Partial seizures: Simple partial seizures: features depend on the part of the brain affected, result from discharge in the precentral gyrus. Consciousness is unimpaired. Complex partial seizures (temporal lobe epilepsy): Consciousness is impaired with complex, often repetitive, action. The EEG in seizure of Epilepsy Epilepsy Pathogenesis: The neuron in brain lesion depolarizes together suddenly, and then product high-frequency ,out-break discharge. The discharge can diffuse to surrounding normal tissue →extensive excitation →the brain function transient aberration. Epilepsy Therapeutic principle: Change the permeability of Na+, Ca2+and K+ in nerve cell membrane, degrade excitement stage, extend refractory phase. Directly or indirectly increase CNS levels of GABA. The primary animal models used in anti-epileptic drugs research Classification of Antiepileptic Drugs Hydantoins：Sodi