What Is the Pathophysiology?
In 2017 a research published in pharmacology and therapeutics for dentistry revealed the exact pathophysiology for a seizure. It showed that there are different types of epilepsy and seizure known to date. All of them have diverse symptoms. However, the most common sign is that all causes an imbalance between inhibitory as well as exciting drive. The exceptional structure of cortical tissue with its laminar cell layers; encourages the progression of typical neuronal handling. While likewise giving a structure liable to anomalous synchronous action that produces a seizure.
Under typical conditions, excitatory synaptic action firmly managed by inhibitory interneurons; but, hereditary transformation, injury, and firmly improvement disturb this guideline, enabling cortical systems to end up hyperexcitable. Researchers say that partial epilepsy present in approximately 60% of epileptic people. There is a long list of its causes, which include tumors, trauma, stroke, or cortical lesions. Also, genetics has a helpful contribution in partial epilepsy. On the other hand, scientists demonstrated that generalized epilepsy present in 40% of the patient, and its chief cause is related to genetics.
Dale’s principle versus the concept of coexistence:
As said earlier, the pathophysiology of epilepsy is known for the shifting of balance among excitatory and the inhibitory drive. This move happens because of the loss of inhibitory GABA-ergic neurons in the wake of accelerating epileptogenic affronts and the re-establishment of neuronal circuits that support hypersynchrony of the neuronal population. The shortfall in GABA-intervened flagging and enlargement of glutamatergic transmission that reported in many kinds of epilepsy is the chief cause for the pharmacotherapy of several diseases. In overview epilepsy, the glutamate–GABA theory depends on Dale’s guideline. It assumes that the neuropharmacological profile of every neuron characterized by a specific single synapse. However, this guideline got refuted. Thus, the epileptic neuropharmacological premise is increasingly unpredictable and multifaceted.
Reason for coexistence
As opposed to Dale’s standard, the idea of coexistence that says that individual neurons produce, store, and discharge more than one molecule of the messenger. A different group of organically dynamic substances appeared to exist together with a neurotransmitter in a similar neuron and to manage diverse parts of neuronal work. Presently, the contrast between the two classes of neuronal delegates is only semantic; it showed that numerous neuromodulators are significant in forming a neuronal movement and in characterizing the biochemical profile of neurons and neuronal systems as exemplary synapses and play a primary role in the pathophysiology of epilepsy in the brain.
How does the treatment for epilepsy work in the body?
There are many ways of treating epilepsy. Let’s know the working of some of them.
- AEDs – AEDs stands for Anti-epileptic drugs. It is one of the most common treatment methods used to date. It helps in managing seizure I around seventy percent of the people all around. The main principle behind its working is that it changes the chemical level in a person’s brain. It prevents seizures but does not cure epilepsy. There are many types of AEDs:-
- Carbamazepine
- Sodium valproate
- Lamotrigine
- Oxcarbazepine
- Levetiracetam
- Topiramate
- Ethosuximide
You can get AEDs in different forms like liquids, syrups, tablets, and capsules. You must take it every other day. The person who will recommend it to you will start with a low dosage but will uplift it until your seizure stops. If the first AED doesn’t work, then you will be prescribed to take the other one. It is very much necessary that you listen to the words of your doctor. Don’t ever try to consume any other medicine while taking AEDs. It may be harmful to your health.
Brain Surgery – A person can go for brain surgery only if: –
- AEDs are not able to do any changes to the seizure.
- The seizure is present in a small part of the brain that can easily get removed.
The patient is provided with a small amount of anesthetic and made to sleep. Then, the surgeon cut a small portion of the scalp and through a small opening, gets rid of the affected part of the brain. At last, the holes get closed.
But before taking a step towards surgery, one needs to take some tests like: –
- Brain scans.
- EEG (Electroencephalogram).
- Test for mental health and memory.
Ketogenic diet
The best way to treat epilepsy in children and adults is to take keto-diet. This diet got its importance from the year 1920. It is high fat and a low carb diet. Doctors recommend that one should take these diets if AEDs are not working suitably in the body. Ketogenic diet drops down the frequency and strength of seizure. However, you should take this diet under the supervision of a good health doctor.
What are the side-effects of epilepsy treatment?
There are many side effects related to the treatment of epilepsy. Some of the most dangerous ones are from the AEDs. They are as follows:-
- Tiredness
- Absence of vitality
- Disturbance
- Cerebral pains
- Wild shaking (tremor)
- Balding or undesirable hair development
- Swollen gums
- Rashes
If you have gone for any surgery, then remember that it will take you some months to get back to normal. After the surgery, you have to take AEDs for one or two years. AEDs have side effects as discussed earlier but apart from that surgery will also cause harm to you. It may create a problem regarding your mood, memory, and vision. Researchers recommend that you should have a chat with the doctor before your brain surgery.
Can epilepsy be inherited?
Heredity is those traits, which get inherited by children from their parents. It is one of the essential factors that decide the occurrence of epilepsy. It may happen in some cases that a person who got an injury in his head will develop epilepsy while others won’t. Generalized epilepsy is the kind of epilepsy where it generates from both parts of the brain. This epilepsy generally produced by genetic factors. Another category like focal or partial epilepsy affected by an abnormal electrical imbalance in the brain.
It’s a common question from many individuals that if they have epilepsy then, do their children will also have the same. The answer is yes, they will also have epilepsy; but the chances are very low for that. Researchers have proved that: –
- Out of a hundred people, only two of them faces epilepsy during their whole life.
- The chance of getting epilepsy is quite high in the child if his father has it.
- The possibility of getting epilepsy is quite low in the child if his mother has it.
- Chances of some particular epilepsy become high in case both of them have epilepsy.
However, if the epilepsy is hereditary, one should refer to the doctor for medication. It got proved that seizures and epilepsy can get cured with proper medication if it got inherited from the parents.
What are the genes responsible for any epilepsy?
According to the present reports, there is a total of 977 genes related to epilepsy. It divided into four categories.
- Eighty-four of them are epilepsy genes, where epilepsy is the core effect. Some of them are PNPO, ALDH7A1, PRRT2, ST3GAL5, etc.
- Seventy-three of them, related to neurodevelopment where brain growth depletes due to epilepsy. Some of them are PTCH1, OCLN, NSDHL, PIK3R2, FIG4.
- Five hundred and thirty-six of them produced physical as well as other systematic harm and followed by seizure or epilepsy. Some of them are CCM1, KRIT1, CALM2, KCNQ1,
- Two hundred and eighty-four of them are potential-epilepsy gene. They need more verification. Some of them are SCN3A, SCN4A, SCN5A, HCN2, HCN4.
Concluding
To summarize up, seizures attack a person due to an imbalance in the inhibitory GABA neurotransmitter. Several diseases might open the gate for epilepsy to occur. Also, genetic causes or life traumas are triggering the keys to epilepsy. No matter what the reason is, you can manage well your epilepsy. However, if you ignore the case, you will increase the chance of entering a critical case of epilepsy.
Yes, there are multiple approaches for epilepsy therapy. But, you have to keep in mind, the surgeries and other treatments may have their pros and cons. Thus, you shall ask your physician about all the available remedies and their merits and demerits. Unfortunately, some epilepsy types are inherited. Therefore, it is necessary to ask about your parents’ history; to identify whether you have any of the epileptic genes or not. After all, you can find your appropriate medication and reach the expected treatment you want.
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