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Epilepsy Research Paper
Minimal-invasive, ablative surgery. Discovery of diagnostic biomarkers for post-traumatic epileptogenesis — an interim analysis of harmonization procedures in preclinical multicenter trial EpiBios4Rx. Editor's Choice. Largepart of the report has focused on the biological processes that occur within an epileptic 2.
This report does not describe the differenttype of seizures and different types of anti-epileptic drugs but goes in depth to describethe biological process of seizures and new treatments. Seizure and its biochemistryNerve cells are made up of smaller units called neurons that have three main structuresinvolved in transmitting message across the body. These structures are named Axon,Cell body and Dendrites Figure 1.
Based on their functions, neurons are divided intothree. These are the sensory neurons that carry message from our sense organs to thebrain, motor neurons transmit electrical message from the brain to our sense and interneurons process information within the brain. As shown in the Figure 1, there is a smallgap between each neuron called synaptic gap. For message to travel across this gapchemicals called Neurotransmitters have to be released. There are approximately 50neurotransmitters identified today Scott and Maume, At such times, neurons firesan impulse, called an action potential or exciting state, a brief electrical charge thattravel down its axon Mayers, For normal electrochemical message pathway tooccur nerve cells must create a balance between the inhibiting and inducing 3.
A seizureoccurs when the brains nerve cells misfire and generate a sudden, uncontrolled surgeof electrical activity in the brain. It is also called hyper excitable state Schachter, Hyper excitable state can result from the increase of exciting synapticneurotransmitters, decrease of inhibiting neurotransmitters or an alteration in voltage-gated ion channels Bromfield, Cavazos and Sirven, The irregular bodymovement during seizure happens when our sense organs receive mixed messages andtry to execute all at once.
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Traditionally, the diagnosis of epilepsy requires theoccurrence of at least 2 unprovoked seizures 24 hours apart Medscape, extracted on Just before the occurrence of seizure the concentration of glucose and cholesterolin the body decreases Natelson et al, As stated above seizures are classified according to the part of the brain seizure starts. Ifa seizure arises from certain part of the brain, the initial symptoms of the seizure willreflect the functions of those parts.
The left part of the brain controls the right side of thebody and vice versa.
Thus if the seizure arises from the left side of the brain you willfirst observe the movement of the right hand or thumb Schachter, What causes epilepsy? According to national institute of neurological disorders and stroke NINDS , epilepsycan be caused by anything that disturbs the normal pattern of neuron activity — fromillness to brain damage to abnormal brain development.
These all can lead to seizures.
Researchers believe that some people with epilepsy have an imbalance in nervesignaling chemicals called neurotransmitters. In some cases brain attempts to repair itself after sever injuries, which may generateabnormal nerve connections that leads to epilepsy Foundation for better health FBHC , Listed below are causes of epilepsy.
Due to the vast variations for the causes of epilepsythey are categorised in five main groups. Brain chemistryThis is caused by imbalance in neurotransmitters.
Neurotransmitters are chemicalsfound in our nerve cells, which help transport electrical messages across the synapticgap between adjacent nerve cells. There is a fine balance between factors that spreadelectrical message and the ones that limit it. When neurotransmitters that induce orinhibit impulse are found at high concentration this balance will break apart causing anabnormal electrical discharge.
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The abnormal electrical discharge causes a seizure. Prenatal InjuriesPrenatal injuries are damages caused to fetus before birth. The developing brain is verysensitive to different kinds of injuries. If a pregnant woman eats unbalanced diet,smokes, has an infection, or abuses drugs and alcohol the developing brain will behighly susceptible to prenatal injuries such as cerebral palsy Mayo clinic stuff, Cerebral palsy is a term given to a group of disorders that can involve brain andnervous system, functions like thinking and movement.
Prenatal injuries increase the chance ofdeveloping epilepsy. Hereditary causesSome types of epilepsy run in the family which suggest that there is a genetic base forepilepsy. Genetic abnormalities can cause subtle change in the way a body process bio-chemicals. A careful analysis of the relationship between ion channels and neurotransmitterrelease reveals that defects in ion channel function could result in altered synaptictransmission Kapur, These altered synaptic transmissions can cause imbalancedelectrical discharge.
In most cases genetic abnormalities are only partial causes.
Epilepsy and Seizures Treatment & Management
Theyincrease the chance of a person having seizures but never induce seizures. Environmental causesThere are many environmental factors that cause epilepsy. Use of drugs and alcohol,lack of sleep, stress, exposure to lead, and carbon monoxide are the leading causes. These chemicals are poisonous. They affect hormonal production and nerve path in ourbody. Researchers warned that the risk of seizures may be much higher afterconsuming three or more alcoholic beverages Schachter, What are the treatments for epilepsy?
A recent study has also suggested auricular acupuncture as a possible solution tosuppress epileptic seizures He, Most, but not all, patients with epilepsy seizures respond well to available medications. Theseinclude insertion of medical devices and in most difficult scenarios surgery will beperformed.
Some type of seizures can be controlled by special diet called ketogenic diet. The ketogenic diet is a very high fat diet with a minimum amount of sugar. This diet iscarefully planned with nutritionist and must be started in hospital. Patients on theketogenic diet have to take a lot of vitamins because the diet is imbalanced. The dietmimics aspect of starvation by forcing the body to burn fat instead of carbohydrates.
When carbohydrates are present in food they will be converted to glucose and aretransported to the brain. However if there is very little carbohydrate present in the food,liver will convert the fat into fatty acids and ketone bodies. The ketone bodies willreplace carbohydrates as energy source. The buildup of these ketone bodies willdecrease the frequency of epileptic seizures Wilder and Winter, Half of thechildren who stop the diet within a year have reduced epileptic seizures and 20 percentof these had become seizure-free without surgery March et al, Vagus nerve stimulation VNS is another method used to treat epilepsy.
A pacemakertype device is inserted to generate continuous electrical impulse to stimulate the vagusnerve cell. The vagus nerve cell is one of the 12 cranial nerves found in our body. Nervecells that emerge from the brain are called cranial nerves cells. The device containslithium battery and microprocessor enclosed in titanium case. It transmits electricalimpulse according to the program set before the insertion.
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Deeper infections occur in about 3 to 5 percent of the patients. Mildcases can be treated by antibiotics EL et al, If a seizure is refractory to all forms of medication,then the patient is subjected to surgery. The other group of patients that are candidatefor surgery are those who have certain characteristics that suggest surgical interventioncan be curative Cosgrove and J. Cole, Surgery only works when a small area ofdamaged brain like a tumor, or a scar, or a tangle of abnormal blood vessels is causingthe seizures.
Presurgical evaluations are done on each patient before surgery. Theseevaluations include detailed clinical history and physical examination, advanced neuro-imaging, video-EEG monitoring, neuropsychological testing and assessment ofpsychosocial functioning. The goal of epilepsy surgery is to identify area of cortex thatis affected and remove it without causing any significant damage to the brain Cosgroveand J.
It is now well established that AED are not fully effective to control seizure inabout one quarter to one third of patients Kwan and Brodi2, Therefore, currentlycombinations of the above treatments are being used. ConclusionAs seen from the report epilepsy is one of the very common chronic disorders affecting50 million people worldwide. An estimated 2.