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PsychomotorseizuresPetitmal(absence)Grandmal(tonic-clonic)Epilepsyisnotasingleentity;itisafamilyofdifferentrecu

rrentseizuredisordersthathaveincommonthesudden,excessiveanddisorderlydischargeofcentralneurons.Thisresultsinabnormalmovementorperceptionsthatare

ofshortdurationbutthattendtorecur.Classificationofepilepsy(older)Generalizedseizures(全身发作）Grandmal（大发作）：to

nic-clonicseizures（强直－阵挛）Petitmal（小发作）：absenceseizures（失神发作）Partialseizures(部分性发作)Pshychomotor（精神运动性）：temporallobeseizures（颞叶癫痫）Partial（部分发作）：mot

or,sensory,ANS,etc.（局限性发作）ClassificationofepilepsyNormalEEGAbsenceEEGThepathwaysforseizurepropagationinpartials

eizuresandprimarygeneralizedseizuresStereotypicalcomplexpartialseizuresIneffectiveforpetitmal(absenceseizures)(3)AntiarrhythmiaNecessarytomonitorp

lasmaconcentrations(1)Grandmal/Partial：BroadspectrumofantiepilepsyIneffectiveforpetitmal(absenceseizures)Phenytoin,Carbamazepine,PhenobarbitalAdverse

effects：AntiepilepticdrugsHepatictoxicityGrandmal,statusepilepticus;Mephenytoin美芬妥英,Ethotoin乙苯妥英：analo

guesofphenytoinInductionofhepaticdrug-metabolizingenzymes(3)Antiarrhythmia(3)AntiarrhythmiaAntiepilepticdrugsPsychomotorseizuresLamotrigin

e拉莫三嗪Primidone,ValproatesodiumPrincipalsofantiepilepticdrugusesMechanismsofantiepilepticdrugsElectrophysiologicalInhibitingexcessivedischarges

InhibitingspreadofdischargesMolecularPotentiatingGABAneuronalfunctionsModulatingNa+,Ca2+,K+channelfuctions

A.AntiepilepticdrugsSpecialdrugsPhenytoinSodium苯妥英钠CONNHC6H5C6H5NaO1.PharmacologicaleffectsandthemechanismInhibitinginfluxofNa+andCa2+Inhibitingspr

eadofabnormaldischargesA.Antiepilepticdrugs2.Clinicaluses(1)AntiepilepsyGrandmal,statusepilepticus;Partialseizures(s

impleandcomplex);Ineffectiveforpetitmal(absenceseizures)(2)Trigeminalandrelatedneuralgia(3)AntiarrhythmiaA.Antiepilepticdrugs3.ADMELargerdoses:

non-linearkinetics（plasmaconcentration>10g/ml）NecessarytomonitorplasmaconcentrationsInductionofhepaticdrug-metabolizingenzymesA.Antiepil

epticdrugs3.Adverseeffects(1)LocalreactionsGIreactions;gingivalhyperplasia(2)CNSreactionsParticularlyinthecerebellumandvestibularsys

tems:nystagmus(眼球震颤),ataxia(共济失调),etc.Behavioralchanges:confusion,hallucinationA.Antiepilepticdrugs(3)HemologicalreactionsMegal

oblasticanemia(4)AllergicreactionsSkinreactions;bloodcellabnormality(includingthrombocytopenia,agranulocyt

osis);hepatictoxicity;ect.(5)SkeletalreactionsOsteomalaciabyabnormalvitaminDmetabolismandcalciumabsorptionA.Antiepilepticdrugs4.Drugin

teractions(1)Increasesplasmaconcentrationsofdrugsbydisplacementofplasmaproteinbinding(salicylates)andinhibiti

onofinactivation(isoniazid,chloramphenicol)(2)Decreasesplasmaconcentrationsofdrugs(phenobarbital,carbamazepine)byenhanci

ngmetabolism(3)PhenytoinenhancesthemetabolismofcorticosteroidsandvitaminDA.AntiepilepticdrugsEffectiveforpsychomotorseizures,andgrandmalEpileps

yisnotasingleentity;itisafamilyofdifferentrecurrentseizuredisordersthathaveincommonthesudden,excessiveanddisorderlydischargeofcen

tralneurons.(2)TrigeminalandrelatedneuralgiaPhenytoin,Carbamazepine,PhenobarbitalThisresultsinabnormalmovementorperceptionsthatareofs

hortdurationbutthattendtorecur.OtheranticovulsantdrugsParticularlyinthecerebellumandvestibularsystems:nystagmus(眼球震颤),ataxia(共济失调),etc.Adverseeffe

ctsPartial（部分发作）：Primidone,ValproatesodiumDruginteractionsPartialseizures(simpleandcomplex);Phenytoin,Carbamazepine,PhenobarbitalI

nhibitingspreadofdischargesCHCOOHPrincipalsofantiepilepticdrugusesPetitmal（小发作）：ClassificationofepilepsyPrincipalsofantiepilepti

cdrugusesvasodilatation,BP;(1)AntiepilepsyInhibitingbothformationandspreadofdischargesEffectiveforgrandmal,partialsimpleseizures,statusepilepticu

sPhenobarbital苯巴比妥A.AntiepilepticdrugsC2H5CONHNHCOCOCC6H5Effectiveforpsychomotorseizures,andgrandmalEffectiveformania,depression,

andneuralgiaCarbamazepine卡马西平NCONH2A.AntiepilepticdrugsBroadspectrumofantiepilepsyHepatictoxicityValproatesodium丙戊酸钠A.AntiepilepticdrugsCH3CH2C

H2CHCOOHCH3CH2CH2OtherantiepilepticdrugsPrimidone扑米酮：analoguesofphenobarbital,usedforphenobarbital-andph

enytoin-ineffectivepatientsMephenytoin美芬妥英,Ethotoin乙苯妥英：analoguesofphenytoinEthosuximide乙琥胺：peptitmalDiazepam:status

epilepticus(i.v.)Nitrozepam硝西泮,Clonazepam氯硝西泮：peptitmalLamotrigine拉莫三嗪A.AntiepilepticdrugsBoxCommontoxici

tyofantiepilepticdrugs:CNSreactionsHemologicalreactionsHepatictoxicityA.Antiepilepticdrugs(1)AntiepilepsyPrimido

ne,ValproatesodiumplasmaconcentrationmonitoringifnecessaryClassificationofepilepsy(older)CHCOOHParticularlyinthece

rebellumandvestibularsystems:nystagmus(眼球震颤),ataxia(共济失调),etc.AntiepilepticdrugsInductionofhepaticdrug-metabolizingenzymes),Phenobrbit

al(i.Effectiveforpsychomotorseizures,andgrandmalClassificationofepilepsy(older)Partialseizures(simplea

ndcomplex);Otheranticovulsantdrugs(2)Peptitmal:Ethosuximide(2)CNSreactions(3)Phenytoinenhancesthemeta

bolismofcorticosteroidsandvitaminDChoiceofdrugs(1)Increasesplasmaconcentrationsofdrugsbydisplacementofplasmaprotei

nbinding(salicylates)andinhibitionofinactivation(isoniazid,chloramphenicol)hypertensioncrisis),Pheno

brbital(i.Mechanismsofantiepilepticdrugsvasodilatation,BP;smalllargerdoses;hypertensioncrisistonic-clonicseizures（强直－阵挛）Primidon

e,ValproatesodiumClinicaluses(2)Peptitmal:EthosuximiderelaxingskeletalmusclesCHCOOHInhibitingbothformationandspreadofdischa

rgesCHCOOHStereotypicalcomplexpartialseizures(2)CNSreactionsSpecialdrugsAntiepilepticdrugsNecessaryt

omonitorplasmaconcentrationsOtheranticovulsantdrugsMechanismsofantiepilepticdrugsIneffectiveforpetitmal(absen

ceseizures)temporallobeseizures（颞叶癫痫）doseindividualization;Principalsofantiepilepticdruguses1.Choiceofdrugs(1)Grandmal/Partial：Phen

ytoin,Carbamazepine,PhenobarbitalPrimidone,Valproatesodium(2)Peptitmal:EthosuximideClonazepam,Valproat

esodium(3)Psychomotor：Carbamazepine,Phenytoin(4)Statusepilepticus：Diazepan(i.v.)Phenytoin(i.v.),Phenobrbital(i.m.)A.Antiepile

pticdrugs2.Dosage：small→largerdoses;doseindividualization;plasmaconcentrationmonitoringifnecessary3.Usage：drugcombination4.Withdrawal：gradually

andslowlyA.Antiepilepticdrugs1.Effects：centraldepression;vasodilatation,BP;relaxingskeletalmuscles2.Uses：convulsion；hypertensioncrisis

3.Adverseeffects：depressionofrespiratoryandvasomotorcenters,antagonizedbycalciumpreparations(i.v.)MagnesiumSulfate硫酸镁A.AnticonvulsantdrugsOt

heranticovulsantdrugsSedative-hypnoticdrugsA.Anticonvulsantdrugs