Changes

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. 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>

One of the reasons for epilepsy development is the genetic background. While the exact background is still unknown, there are certain genes that were found to be involved in the progression of the epilepsy, for example SCN1A and SCN8A that are active in the production of sodium channels and can therefore contribute to the epilepsy succession. <ref name=”[14]”> Guo, W., Shang, D.-M., Cao, J.-H., Feng, K., He, Y.-C., Jiang, Y., … Gao, Y.-F. (2017). Identifying and Analyzing Novel Epilepsy-Related Genes Using Random Walk with Restart Algorithm. Introduction , at [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5309434/ “https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5309434/”].</ref>

“h https://www.ncbi.nlm.nih.gov/pubmed/28276060

”].</ref>

===Valproate Mode of Action===

The exact mode of action of valproate on molecular level is unknown, as there are many different substances that participate simultaneously in the regulation of neuronal activity. <ref name=”[15]”> Sodium valproate (Epilim, Epival, Episenta). (2018, June 5) , at [https://www.netdoctor.co.uk/medicines/brain-nervous-system/a6665/epilim-sodium-valproate/ “https://www.netdoctor.co.uk/medicines/brain-nervous-system/a6665/epilim-sodium-valproate/”].</ref> VPA is connected to cortical inhibition in order to contribute to ‘neural synchrony’ and is known to provide protection from neural degradation and damage. <ref name=”[16]”> Williams, R. S. B., Cheng, L., Mudge, A. W., & Harwood, A. J. (2002). A common mechanism of action for three mood-stabilizing drugs , at [https://www.nature.com/articles/417292a “https://www.nature.com/articles/417292a”].</ref>