Pathophysiology of Epilepsy

         Etiopathologically, epileptic seizure can be caused by head injury, stroke, brain tumors, brain infections, poisoning, or even the growth of abnormal nerve tissue (neurodevelopmental problems), the influence of the genetic mutations that cause. Genetic mutations and cell damage in the physical injury or stroke or tumor will lead to changes in the function and structure of the regulatory mechanisms that lead to impaired neuronal growth-and plasticity at synapses. Change (focus) is what can lead to generation of electricity in the brain. 

       Epileptic seizure can also occur without anatomical damage found (focus) in the brain. On the other hand epilepsy will also be able to lead, abnormalities of brain tissue that can lead to physical dysfunction and mental retardation.

         From the point of view of molecular biology, epileptic seizure is caused by an imbalance of secretion and function of excitatory and inhibitory neurotransmitters in the brain. This situation could be due to the secretion of neurotransmitters from presynaptic uncontrolled which further contribute to synaptic NMDA or AMPA receptors in post-synaptic. Involvement of NMDA receptor subtype of glutamate receptor (NMDAR) is described as the pathology of seizures and epilepsy.
     Pharmacologically, inhibition of NMDAR is the working principle of antiepileptic drugs. Some neurogenetic research proves that some factors are responsible for the generation of epilepsy among other abnormalities in the ligand-gated (sub-unit of the nicotinic receptor) as well as the voltage-gated (sodium and potassium channels). This is evident in the frontal lobe epilepsy who apparently has to do with the occurrence of mutations in the alpha subunit of the nicotinic resepot.
        Speaking about the role of the sodium ion channels, potassium and calcium ions are involved in the communication system via receptor neurons. Entry and exit of these ions generate the required electricity generation in sesame neuron communication. If there is damage or abnormalities in ion channel is the generation of electricity will also impaired, as in patients with epilepsy. This ion channel plays a role in the work of certain neurotransmitter receptors. In the case of epilepsy known as a neurotransmitter gamma aminobutyric acid (GABA), which is known as inhibitory, glutamate (excitatory), serotonin (which still remain in relation to epilepsy research, acetylcholine in the hippocampus are known to be responsible for memory and learning.
        Variety of diseases can cause changes in the balance between inhibitors and excitatory neurons, for example heriditer abnormalities, congenital, hypoxia, infection, tumor, vascular, drug or toxin. The disorder can cause damage or increased factor inhibition and excitation functions of neurons, making it easy epilepsy arises when there is an adequate stimulus.

        Areas that are prone to damage, if any brain abnormalities, such as in the hippocampus. Therefore any seizures always cause an increase excitability of neurons, the seizures tend to recur and subsequently cause more extensive damage. On examination of the brain tissue of epilepsy patients who die are always found damage in the hippocampus. It is therefore not surprising that more than 50% of partial epilepsy, focal temporal lobe origin are where there is the place of origin of the hippocampus and acquired epilepsy.
      In infants and children, are still immature neuronal cells are susceptible to the effects of traumatic, metabolic disorders, circulatory disorders, infections and so on. This effect can be obliteration of neurons and glia cells or damage to neurons or glia, which in turn can make neurons or glia epileptogenic neuronal environment. Brain damage caused by trauma, infection, metabolic disorders and so on, all of which can develop epilepsy. However, children without brain damage can also be epilepsy, in this case considered the cause of genetic factors, especially grand mal and petit mal epilepsy and centrotemporal Benigne. Nevertheless, the underlying process idiopathic epileptic seizures, through the same mechanism.
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