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)


Migraine : Migraine is a chronic neurological disorder characterized by recurrent moderate to severe headaches often in association with a number of autonomic nervous system symptoms. Migraine is a severe, painful headache that is often preceded or accompanied by sensory warning signs such as flashes of light, blind spots, tingling in the arms and legs, nausea, vomiting, and increased sensitivity to light and sound. Medication Preventive migraine medications are considered effective if they reduce the frequency or severity of the migraine attacks by at least 50%. Guidelines are fairly consistent in rating topiramate, divalproex/sodium valproate, propranolol, and metoprolol as having the highest level of evidence for first-line use. Recommendations regarding effectiveness varied however for gabapentin. Timolol is also effective for migraine prevention and in reducing migraine attack frequency and severity, while frovatriptan is effective for prevention of menstrual migraine. Amitriptyline and venlafaxine are probably also effective. Angiotensin inhibition by either an angiotensin-converting enzyme inhibitor orangiotensin II receptor antagonist may reduce attacks. Botox has been found to be useful in those with chronic migraines but not those with episodic ones.