Epilepsy : Epilepsy is a brain disorder in which clusters of nerve cells, or neurons, in the brain sometimes signal abnormally. Neurons normally generate electrochemical impulses that act on other neurons, glands, and muscles to produce human thoughts, feelings, and actions. In epilepsy, the normal pattern of neuronal activity becomes disturbed, causing strange sensations, emotions, and behavior, or sometimes convulsions, muscle spasms, and loss of consciousness. During a seizure, neurons may fire as many as 500 times a second, much faster than normal. In some people, this happens only occasionally; for others, it may happen up to hundreds of times a day. EPILEPSY SYMPTOMS • Generalized seizures: All areas of the brain (the cortex) are involved in a generalized seizure. Sometimes these are referred to as grand mal seizures. o The person experiencing such a seizure may cry out or make some sound, stiffen for several seconds to a minute and then have rhythmic movements of the arms and legs. Often the rhythmic movements slow before stopping. o Eyes are generally open. o The person may appear to not be breathing and actually turn blue. This may be followed by a period of deep, noisy breathes. o The return to consciousness is gradual and the person may be confused for quite some time –minutes to hours. o Loss of urine is common. o The person will frequently be confused after a generalized seizure. • Partial or focal seizures: Only part of the brain is involved, so only part of the body is affected. Depending on the part of the brain having abnormal electrical activity, symptoms may vary. o If the part of the brain controlling movement of the hand is involved, then only the hand may show rhythmic or jerky movements. o If other areas of the brain are involved, symptoms might include strange sensations like a full feeling in the stomach or small repetitive movements such as picking at one's clothes or smacking of the lips. o Sometimes the person with a partial seizure appears dazed or confused. This may represent a complex partial seizure. The term complex is used by doctors to describe a person who is between being fully alert and unconscious. • Absence or petit mal seizures: These are most common in childhood. o Impairment of consciousness is present with the person often staring blankly. o Repetitive blinking or other small movements may be present. o Typically, these seizures are brief, lasting only seconds. Some people may have many of these in a day DRUGS: Medicines that may be used first to treat epileptic seizures include: • Carbamazepine (such as Carbatrol). • Ethosuximide (Zarontin), for absence seizures only. • Oxcarbazepine (Trileptal). • Phenobarbital (Luminal). Phenobarbital is a first-line medicine for newborns. • Phenytoin (Dilantin, Phenytek) or fosphenytoin (Cerebyx). • Primidone (Mysoline). The body converts primidone into phenobarbital. • Topiramate (Topamax). • Valproate (Depakene, Depakote). If epileptic seizures continue even though you are being treated, may prescribe one or more of the following medicines: • Benzodiazepines (such as Klonopin) • Ezogabine (Potiga) • Felbamate (Felbatol) • Gabapentin (Neurontin) • Lacosamide (Vimpat). This medicine can be used along with other antiseizure medicine to treat partial seizures. • Lamotrigine (Lamictal) • Levetiracetam (Keppra) • Phenobarbital (Luminal). Phenobarbital is a first-line medicine for newborns. • Pregabalin (Lyrica). This medicine is intended to be used along with other antiseizure medicine. • Primidone (Mysoline). The body converts primidone into phenobarbital. • Rufinamide (Banzel). This medicine can be used along with other antiseizure medicine to treat seizures caused by Lennox-Gastaut syndrome. • Tiagabine (Gabitril) • Topiramate (Topamax) • Vigabatrin (Sabril) • Zonisamide (Zonegran)


Anxiety Disorder : DEFINITION Anxiety can be described as an uncomfortable feeling of vague fear or apprehension accompanied by characteristic physical sensations. It is a normal and often beneficial response to situations that humans perceive as threatening, frightful, or otherwise disturbing. PATHOPHYSIOLOGY A neurocircuit arising from the output pathways of the central nucleus of the amygdala is thought to mediate fear and anxiety responses in humans.Dysregulated or exaggerated output through various amygdala-related circuits may be a common element underlying the different anxiety disorders, but the specific type of dysfunction probably differs among the various disorders. Several neurotransmitter systems have been linked to the neurobiology of anxiety: the inhibitory amino acid, ?-aminobutyric acid (GABA); the monoamine neurotransmitters, serotonin and norepinephrine; the excitatory amino acid, glutamate; and the neuropeptides, cholecystokinin (CCK), corticotrophin-releasing factor (CRF), neuropeptide Y (NPY), and substance P.2,3 Much of the evidence for these biologic processes has come from research on drugs that are used either to treat anxiety or to induce anxiety. Discovery of the anxiolytic effects of benzodiazepines in the early 1960s marked the beginning of this era of research. However, the anxiety-reducing properties of alcohol and barbiturates were recognized long before that time.


Neuralgia : DEFINITION Neuralgia can be defined as a painful disorder of nerves. Pain follows the path of specific nerve, which means severe pain in the course of distribution of nerve due to irritation or damage to the nerve. TRIGEMINAL NEURALGIA- “It is a condition characterized by sudden, brief and severe recurrent pain which involve the distribution of one or more branch of the fifth cranial nerve.” PATHOPHYSIOLOGY Paroxysmal attacks of facial or frontal pain lasting for few seconds to minutes. Pain occurs in lips, gums, cheeks, chin. Sudden, intense, sharp, superficial, stabbing or electric shock like burning will be present. Precipitation from triggering factors may worsen the condition. Small area of the face or may spread Glossopharyngeal neuralgia After nerve fiber damaged during herpetic zoster infection GN starts. Damaged nerve fibers cannot send electrical signals. Erratic or exaggerated causing chronic, excruciating pain in GN.Persists or recur for months or even years.


Epilepsy : Epilepsy is a brain disorder in which clusters of nerve cells, or neurons, in the brain sometimes signal abnormally. Neurons normally generate electrochemical impulses that act on other neurons, glands, and muscles to produce human thoughts, feelings, and actions. In epilepsy, the normal pattern of neuronal activity becomes disturbed, causing strange sensations, emotions, and behavior, or sometimes convulsions, muscle spasms, and loss of consciousness. During a seizure, neurons may fire as many as 500 times a second, much faster than normal. In some people, this happens only occasionally; for others, it may happen up to hundreds of times a day. EPILEPSY SYMPTOMS • Generalized seizures: All areas of the brain (the cortex) are involved in a generalized seizure. Sometimes these are referred to as grand mal seizures. o The person experiencing such a seizure may cry out or make some sound, stiffen for several seconds to a minute and then have rhythmic movements of the arms and legs. Often the rhythmic movements slow before stopping. o Eyes are generally open. o The person may appear to not be breathing and actually turn blue. This may be followed by a period of deep, noisy breathes. o The return to consciousness is gradual and the person may be confused for quite some time –minutes to hours. o Loss of urine is common. o The person will frequently be confused after a generalized seizure. • Partial or focal seizures: Only part of the brain is involved, so only part of the body is affected. Depending on the part of the brain having abnormal electrical activity, symptoms may vary. o If the part of the brain controlling movement of the hand is involved, then only the hand may show rhythmic or jerky movements. o If other areas of the brain are involved, symptoms might include strange sensations like a full feeling in the stomach or small repetitive movements such as picking at one's clothes or smacking of the lips. o Sometimes the person with a partial seizure appears dazed or confused. This may represent a complex partial seizure. The term complex is used by doctors to describe a person who is between being fully alert and unconscious. • Absence or petit mal seizures: These are most common in childhood. o Impairment of consciousness is present with the person often staring blankly. o Repetitive blinking or other small movements may be present. o Typically, these seizures are brief, lasting only seconds. Some people may have many of these in a day DRUGS: Medicines that may be used first to treat epileptic seizures include: • Carbamazepine (such as Carbatrol). • Ethosuximide (Zarontin), for absence seizures only. • Oxcarbazepine (Trileptal). • Phenobarbital (Luminal). Phenobarbital is a first-line medicine for newborns. • Phenytoin (Dilantin, Phenytek) or fosphenytoin (Cerebyx). • Primidone (Mysoline). The body converts primidone into phenobarbital. • Topiramate (Topamax). • Valproate (Depakene, Depakote). If epileptic seizures continue even though you are being treated, may prescribe one or more of the following medicines: • Benzodiazepines (such as Klonopin) • Ezogabine (Potiga) • Felbamate (Felbatol) • Gabapentin (Neurontin) • Lacosamide (Vimpat). This medicine can be used along with other antiseizure medicine to treat partial seizures. • Lamotrigine (Lamictal) • Levetiracetam (Keppra) • Phenobarbital (Luminal). Phenobarbital is a first-line medicine for newborns. • Pregabalin (Lyrica). This medicine is intended to be used along with other antiseizure medicine. • Primidone (Mysoline). The body converts primidone into phenobarbital. • Rufinamide (Banzel). This medicine can be used along with other antiseizure medicine to treat seizures caused by Lennox-Gastaut syndrome. • Tiagabine (Gabitril) • Topiramate (Topamax) • Vigabatrin (Sabril) • Zonisamide (Zonegran)


Anxiety Disorder : DEFINITION Anxiety can be described as an uncomfortable feeling of vague fear or apprehension accompanied by characteristic physical sensations. It is a normal and often beneficial response to situations that humans perceive as threatening, frightful, or otherwise disturbing. PATHOPHYSIOLOGY A neurocircuit arising from the output pathways of the central nucleus of the amygdala is thought to mediate fear and anxiety responses in humans.Dysregulated or exaggerated output through various amygdala-related circuits may be a common element underlying the different anxiety disorders, but the specific type of dysfunction probably differs among the various disorders. Several neurotransmitter systems have been linked to the neurobiology of anxiety: the inhibitory amino acid, ?-aminobutyric acid (GABA); the monoamine neurotransmitters, serotonin and norepinephrine; the excitatory amino acid, glutamate; and the neuropeptides, cholecystokinin (CCK), corticotrophin-releasing factor (CRF), neuropeptide Y (NPY), and substance P.2,3 Much of the evidence for these biologic processes has come from research on drugs that are used either to treat anxiety or to induce anxiety. Discovery of the anxiolytic effects of benzodiazepines in the early 1960s marked the beginning of this era of research. However, the anxiety-reducing properties of alcohol and barbiturates were recognized long before that time.


Neuralgia : DEFINITION Neuralgia can be defined as a painful disorder of nerves. Pain follows the path of specific nerve, which means severe pain in the course of distribution of nerve due to irritation or damage to the nerve. TRIGEMINAL NEURALGIA- “It is a condition characterized by sudden, brief and severe recurrent pain which involve the distribution of one or more branch of the fifth cranial nerve.” PATHOPHYSIOLOGY Paroxysmal attacks of facial or frontal pain lasting for few seconds to minutes. Pain occurs in lips, gums, cheeks, chin. Sudden, intense, sharp, superficial, stabbing or electric shock like burning will be present. Precipitation from triggering factors may worsen the condition. Small area of the face or may spread Glossopharyngeal neuralgia After nerve fiber damaged during herpetic zoster infection GN starts. Damaged nerve fibers cannot send electrical signals. Erratic or exaggerated causing chronic, excruciating pain in GN.Persists or recur for months or even years.