Epilepsy pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

Overview

It is understood that epileptic seizure is the result of uncontrolled unusual synchronized, localized or widely distributed neuronal electrical discharges. The underlying event in all types of seizures is the paroxysmal depolarization shift (PDS) which also causes the EEG changes. In a normal circumstance we have a refractory period after every action potential, but in PDS, the absence of refractory period causes a prolonged membrane depolarization. In order to cause a seizure, so many PDSs most happen in the same time. Any alternation in a synaptic characteristics such as amount of neurotransmitters, function of inhibitory neurons, function of excitatory neurons, synaptic structure and ion channels involved in neurotransmitter release and conduction of action potential can prone a person to epilepsy. In focal epilepsy, epileptiform activity starts in a specific area of brain. It can further spread and cause secondary generalized seizure. In generalized epilepsy seizures occur in both cerebral hemispheres simultaneously or spread so fast from one to another that in EEG, we can see bilateral epileptiform activity from the start.

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Physiology

By Original by en:User:Chris 73, updated by en:User:Diberri, converted to SVG by tiZom - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=2241513

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References

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