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Pathophysiology of epilepsy
Epilepsy is a disease of the central nervous system caused by disruptions in the electrical communication between neurons, more specifically, the imbalance in excitatory and inhibitory action of neurotransmitters at the synapses, which can lead to seizures, loss of awareness or unusual behavior. <ref name=”[13]”> Flyyn, S., & Babi, M. A. (2017). Pathophysiology of Epilepsy.Paragraph Anticonvulsants , at [https://www.sciencedirect.com/topics/medicine-and-dentistry/pathophysiology-of-epilepsy “https://www.sciencedirect.com/topics/medicine-and-dentistry/pathophysiology-of-epilepsy”].</ref> A seizure occurs when there is a large depolarization of many neurons that fire the action potential at the same time. This paroxysmal depolarizing shift can last for thirty seconds up to two minutes and leads the above mentioned effects.  Epileptic seizures appear in two types: focal and generalized. The focal seizure starts in one part of the brain, but due to the failure of inhibitory mechanisms it can spread further. The cause of it can be a trauma or cortex developmental disorder <ref name=”[43]”> (Nall, R. R. (2018, January 23). What are simple partial seizures? Retrieved December 7, 2019, at [ https://www.medicalnewstoday.com/articles/320696.php“ https://www.medicalnewstoday.com/articles/320696.php”].</ref> <ref name=”[44]”> (Leventer, R. J., Guerrini, R., & Dobyns, W. B. (2008, March 1). Malformations of cortical development and epilepsy. Retrieved December 7, 2019, at [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181860/“https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181860/”].</ref> The generalized seizure, on the other hand, is characterized by a sudden and large activity that occurs in more than one area of the brain at the same time, causing the hyperexcitability in the cortex and the neurons that connect the thalamus to the cortex. <ref name=”[38]”> (2016, May 22).2-Minute Neuroscience: Epilepsy. Retrieved November 26, 2019, at [https://www.youtube.com/watch?v=OGFQhLPaaOQ “https://www.youtube.com/watch?v=OGFQhLPaaOQ”].</ref>
Epileptic seizures appear in two types: focal and generalized. The first type of focal seizures is the one without loss of consciousness, but with jerking of different body parts or a change in the perception of reality. The second type is focal seizures with impaired consciousness or change of awareness. On the other hand, generalized epilepsy types are absence seizures, tonic seizures, atonic seizures, clonic seizures and so on. <ref name=”[36]”> Epilepsy. (2019, August 10), at [https://www.mayoclinic.org/diseases-conditions/epilepsy/symptoms-causes/syc-20350093 “https://www.mayoclinic.org/diseases-conditions/epilepsy/symptoms-causes/syc-20350093”].</ref>
Focal seizures include automatisms, behavior arrest, hyperkinetic, autonomic, cognitive and emotional, while atonic, clonic, epileptic spasms, myoclonic and tonic seizures can be both focal or generalized. Generalized seizure types are absence with eyelid myoclonida, myoclonic absence, myoclonic - atonic, myoclonic - tonic - clonic. <ref name=”[42]”> Fisher, R. S., Cross, J. H., French, J. A., Higurashi, N., Hirsch, E., Jansen, F. E., … Zuberi, S. M. (2017, April). Operational classification of seizure types by the International League Against Epilepsy: Position Paper of the ILAE Commission for Classification and Terminology, at [ https://www.ncbi.nlm.nih.gov/pubmed/28276060
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