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Epilepsy, https://www.sciencedirect.com/topics/pharmacology-toxicology-and…
Epilepsy
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Risk Factor
Stroke
Stroke and other blood vessel (vascular) diseases can lead to brain damage that may trigger epilepsy
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Brain Infection
infections such as meningitis, which causes inflammation in your brain or spinal cord, can increase your risk
Family History
If you have a family history of epilepsy, you may be at an increased risk of developing a seizure disorder
Seizures in Childhood
Children who have seizures due to high fevers generally won't develop epilepsy. The risk of epilepsy increases if a child has a long fever-associated seizure, another nervous system condition or a family history of epilepsy
Age
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Epilepsy is most common in children, especially during the first year of life. The rate of epilepsy gradually goes down until the age of 10 then becomes stable.
Incidence/ prevalence
The numbers of people who develop epilepsy over a lifetime (called lifetime prevalence) is higher in blacks than in whites
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Epilepsy is the 4th most common neurological condition and epilepsy affects more than 65 million people worldwide.
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1 in 26 people will develop epilepsy in their lifetime. People with certain conditions may be at greater risk
The estimated proportion of the general population with active epilepsy (i.e. continuing seizures or with the need for treatment) at a given time is between 4 and 10 per 1000 people.
Globally, an estimated 5 million people are diagnosed with epilepsy each year.
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Pathogenesis
typically viewed as the shift in the balance between the inhibitory (γ-aminobutyric acid (GABA)) and the excitatory (glutamate) neurotransmission
disrupted balance between excitatory (via glutamatergic signaling) and inhibitory (via GABAergic signaling) drive at the synaptic level that can result in seizure activity
This shift occurs due to both selective loss of inhibitory GABA-ergic neurons after precipitating epileptogenic insults (e.g., status epilepticus, stroke, and traumatic brain injury) and the reorganization of neuronal circuits that favor hypersynchrony of neuronal populations
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Phases of Seizures
Prodromal
The period from when early symptoms begin to before more obvious, diagnosable symptoms begin.
Ictal
This is the stage of the seizure that most people are familiar with and would identify as a seizure. This stage manifest in many different ways depending on the type of seizure
Post-itcal
The recovery period following a seizure. Some people recover immediately, while others may require minutes, hours or days to feel like they are back at baseline.
Treatments
Medication
Taking an anti-epileptic medication patients can become seizure free or decrease the frequency and intensity of their seizures
Topiramate
Increases GABA activity and inhibiting glutamate activity, blocking neuronal excitability, preventing seizures and migraines
Lamotrigine
Selectively binds and inhibits voltage-gated sodium channels, stabilizing presynaptic neuronal membranes and inhibiting presynaptic glutamate and aspartate release
Carbazepine
Decreases neuro excitability or enhances inhibition by altering sodium, potassium or calcium conductance
Sodium Valporate
Acts on GABA levels in the CNS, blocking voltage-gated ion channels, and inhibiting histone deacetylase
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Therapies
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Deep brain stimulation
Surgeons implant electrodes into a specific area of the brain which sends electrical pulses to your brain at timed intervals
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