https://wiki.sensus.org/index.php?title=Valproate&feed=atom&action=historyValproate - Revision history2024-03-29T07:21:33ZRevision history for this page on the wikiMediaWiki 1.29.2https://wiki.sensus.org/index.php?title=Valproate&diff=136&oldid=prevTechsensus: /* State of the art */2019-12-26T20:15:41Z<p><span dir="auto"><span class="autocomment">State of the art</span></span></p>
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<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>To measure unbound VPA, blood samples are treated by ultrafiltration, followed by an immunoassay, also referred to as ELISA. By performing the ultrafiltration, the protein-bound form of VPA is separated from its unbound form. After that, the level of the unbound fraction can  be measured by an immunoassay, e.g. an ELISA kit. Alternatively, LC-MS can be used to measure VPA.<ref name=”[40]”> ao, S., Miao, H., Tao, X., Jiang, B., Xiao, Y., Cai, F., … Chen, W. (2011, July 1). LC–MS/MS method for simultaneous determination of valproic acid and major metabolites in human plasma, Journal of Chromatography B</div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>To measure unbound VPA, blood samples are treated by ultrafiltration, followed by an immunoassay, also referred to as ELISA. By performing the ultrafiltration, the protein-bound form of VPA is separated from its unbound form. After that, the level of the unbound fraction can  be measured by an immunoassay, e.g. an ELISA kit. Alternatively, LC-MS can be used to measure VPA.<ref name=”[40]”> ao, S., Miao, H., Tao, X., Jiang, B., Xiao, Y., Cai, F., … Chen, W. (2011, July 1). LC–MS/MS method for simultaneous determination of valproic acid and major metabolites in human plasma, Journal of Chromatography B</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>Volume 879, Retrieved November 28, 2019, at [https://www.sciencedirect.com/science/article/pii/S1570023211003278?via=ihub“https://www.sciencedirect.com/science/article/pii/S1570023211003278?via=ihub”].</ref></div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>Volume 879, Retrieved November 28, 2019, at [https://www.sciencedirect.com/science/article/pii/S1570023211003278?via=ihub“https://www.sciencedirect.com/science/article/pii/S1570023211003278?via=ihub”].</ref></div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>Steps such as extraction<del class="diffchange diffchange-inline">, solvent </del>or derivation must be executed prior to a HPLC assay, which takes significant time<ref name=”[29]”> Free Valproic Acid Assay (2014, April). Retrieved from November 3, 2019, at [https://www.cadth.ca/sites/default/files/pdf/lab-tests/06_Free_Valproic_Acid_Assay_e.pdf/“https://www.cadth.ca/sites/default/files/pdf/lab-tests/06_Free_Valproic_Acid_Assay_e.pdf”].</ref></div></td><td class='diff-marker'>+</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>Steps such as <ins class="diffchange diffchange-inline">solvent </ins>extraction or derivation must be executed prior to a HPLC assay, which takes significant time<ref name=”[29]”> Free Valproic Acid Assay (2014, April). Retrieved from November 3, 2019, at [https://www.cadth.ca/sites/default/files/pdf/lab-tests/06_Free_Valproic_Acid_Assay_e.pdf/“https://www.cadth.ca/sites/default/files/pdf/lab-tests/06_Free_Valproic_Acid_Assay_e.pdf”].</ref></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>. CMIA is a special type of ELISA <ref name=”[34]”> Ilyas M., Ahmad. I (2014, July 12), Chemiluminescent microparticle immunoassay based detection and prevalence of HCV infection in district Peshawar Pakistan, third alinea Background, Retrieved from November 7, 2019, at [https://virologyj.biomedcentral.com/articles/10.1186/1743-422X-11-127“https://virologyj.biomedcentral.com/articles/10.1186/1743-422X-11-127”].</ref></div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>. CMIA is a special type of ELISA <ref name=”[34]”> Ilyas M., Ahmad. I (2014, July 12), Chemiluminescent microparticle immunoassay based detection and prevalence of HCV infection in district Peshawar Pakistan, third alinea Background, Retrieved from November 7, 2019, at [https://virologyj.biomedcentral.com/articles/10.1186/1743-422X-11-127“https://virologyj.biomedcentral.com/articles/10.1186/1743-422X-11-127”].</ref></div></td></tr>
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</table>Techsensushttps://wiki.sensus.org/index.php?title=Valproate&diff=135&oldid=prevTechsensus: /* State of the art */2019-12-26T20:13:39Z<p><span dir="auto"><span class="autocomment">State of the art</span></span></p>
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<td colspan='2' style="background-color: white; color:black; text-align: center;">Revision as of 20:13, 26 December 2019</td>
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<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>To measure unbound VPA, blood samples are treated by ultrafiltration, followed by an immunoassay, also referred to as ELISA. By performing the ultrafiltration, the protein-bound form of VPA is separated from its unbound form. After that, the level of the unbound fraction can  be measured by an immunoassay, e.g. an ELISA kit. Alternatively, LC-MS can be used to measure VPA.<ref name=”[40]”> ao, S., Miao, H., Tao, X., Jiang, B., Xiao, Y., Cai, F., … Chen, W. (2011, July 1). LC–MS/MS method for simultaneous determination of valproic acid and major metabolites in human plasma, Journal of Chromatography B</div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>To measure unbound VPA, blood samples are treated by ultrafiltration, followed by an immunoassay, also referred to as ELISA. By performing the ultrafiltration, the protein-bound form of VPA is separated from its unbound form. After that, the level of the unbound fraction can  be measured by an immunoassay, e.g. an ELISA kit. Alternatively, LC-MS can be used to measure VPA.<ref name=”[40]”> ao, S., Miao, H., Tao, X., Jiang, B., Xiao, Y., Cai, F., … Chen, W. (2011, July 1). LC–MS/MS method for simultaneous determination of valproic acid and major metabolites in human plasma, Journal of Chromatography B</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>Volume 879, Retrieved November 28, 2019, at [https://www.sciencedirect.com/science/article/pii/S1570023211003278?via=ihub“https://www.sciencedirect.com/science/article/pii/S1570023211003278?via=ihub”].</ref></div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>Volume 879, Retrieved November 28, 2019, at [https://www.sciencedirect.com/science/article/pii/S1570023211003278?via=ihub“https://www.sciencedirect.com/science/article/pii/S1570023211003278?via=ihub”].</ref></div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del class="diffchange diffchange-inline">In contrast to an HPLC assay, steps </del>such as extraction, solvent or derivation must be executed prior to a HPLC assay, which takes significant <del class="diffchange diffchange-inline">more </del>time<ref name=”[29]”> Free Valproic Acid Assay (2014, April). Retrieved from November 3, 2019, at [https://www.cadth.ca/sites/default/files/pdf/lab-tests/06_Free_Valproic_Acid_Assay_e.pdf/“https://www.cadth.ca/sites/default/files/pdf/lab-tests/06_Free_Valproic_Acid_Assay_e.pdf”].</ref></div></td><td class='diff-marker'>+</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">Steps </ins>such as extraction, solvent or derivation must be executed prior to a HPLC assay, which takes significant time<ref name=”[29]”> Free Valproic Acid Assay (2014, April). Retrieved from November 3, 2019, at [https://www.cadth.ca/sites/default/files/pdf/lab-tests/06_Free_Valproic_Acid_Assay_e.pdf/“https://www.cadth.ca/sites/default/files/pdf/lab-tests/06_Free_Valproic_Acid_Assay_e.pdf”].</ref></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>. CMIA is a special type of ELISA <ref name=”[34]”> Ilyas M., Ahmad. I (2014, July 12), Chemiluminescent microparticle immunoassay based detection and prevalence of HCV infection in district Peshawar Pakistan, third alinea Background, Retrieved from November 7, 2019, at [https://virologyj.biomedcentral.com/articles/10.1186/1743-422X-11-127“https://virologyj.biomedcentral.com/articles/10.1186/1743-422X-11-127”].</ref></div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>. CMIA is a special type of ELISA <ref name=”[34]”> Ilyas M., Ahmad. I (2014, July 12), Chemiluminescent microparticle immunoassay based detection and prevalence of HCV infection in district Peshawar Pakistan, third alinea Background, Retrieved from November 7, 2019, at [https://virologyj.biomedcentral.com/articles/10.1186/1743-422X-11-127“https://virologyj.biomedcentral.com/articles/10.1186/1743-422X-11-127”].</ref></div></td></tr>
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</table>Techsensushttps://wiki.sensus.org/index.php?title=Valproate&diff=134&oldid=prevTechsensus: /* State of the art */2019-12-26T20:12:10Z<p><span dir="auto"><span class="autocomment">State of the art</span></span></p>
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<tr><td class='diff-marker'>−</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>To measure unbound VPA, blood samples are treated by ultrafiltration, followed by an immunoassay, also referred to as ELISA. By performing the ultrafiltration, the bound form of VPA is separated from its unbound form. After that, the level of the unbound fraction can  be measured by an immunoassay, e.g. an ELISA kit. Alternatively, LC-MS can be used to measure VPA.<ref name=”[40]”> ao, S., Miao, H., Tao, X., Jiang, B., Xiao, Y., Cai, F., … Chen, W. (2011, July 1). LC–MS/MS method for simultaneous determination of valproic acid and major metabolites in human plasma, Journal of Chromatography B</div></td><td class='diff-marker'>+</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>To measure unbound VPA, blood samples are treated by ultrafiltration, followed by an immunoassay, also referred to as ELISA. By performing the ultrafiltration, the <ins class="diffchange diffchange-inline">protein-</ins>bound form of VPA is separated from its unbound form. After that, the level of the unbound fraction can  be measured by an immunoassay, e.g. an ELISA kit. Alternatively, LC-MS can be used to measure VPA.<ref name=”[40]”> ao, S., Miao, H., Tao, X., Jiang, B., Xiao, Y., Cai, F., … Chen, W. (2011, July 1). LC–MS/MS method for simultaneous determination of valproic acid and major metabolites in human plasma, Journal of Chromatography B</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>Volume 879, Retrieved November 28, 2019, at [https://www.sciencedirect.com/science/article/pii/S1570023211003278?via=ihub“https://www.sciencedirect.com/science/article/pii/S1570023211003278?via=ihub”].</ref></div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>Volume 879, Retrieved November 28, 2019, at [https://www.sciencedirect.com/science/article/pii/S1570023211003278?via=ihub“https://www.sciencedirect.com/science/article/pii/S1570023211003278?via=ihub”].</ref></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>In contrast to an HPLC assay, steps such as extraction, solvent or derivation must be executed prior to a HPLC assay, which takes significant more time<ref name=”[29]”> Free Valproic Acid Assay (2014, April). Retrieved from November 3, 2019, at [https://www.cadth.ca/sites/default/files/pdf/lab-tests/06_Free_Valproic_Acid_Assay_e.pdf/“https://www.cadth.ca/sites/default/files/pdf/lab-tests/06_Free_Valproic_Acid_Assay_e.pdf”].</ref></div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>In contrast to an HPLC assay, steps such as extraction, solvent or derivation must be executed prior to a HPLC assay, which takes significant more time<ref name=”[29]”> Free Valproic Acid Assay (2014, April). Retrieved from November 3, 2019, at [https://www.cadth.ca/sites/default/files/pdf/lab-tests/06_Free_Valproic_Acid_Assay_e.pdf/“https://www.cadth.ca/sites/default/files/pdf/lab-tests/06_Free_Valproic_Acid_Assay_e.pdf”].</ref></div></td></tr>
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<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>Several innovations are being investigated for VPA testing. For example, 2D-LC system (two-dimensional chromatography) was studied, allowing large volume injection, reducing interfering components, and reducing the analysis time and preventing most interference components by selecting useful sections in the “heart-cut” column(1D) from entering the analysis column (2D).<ref name=”[11]”>  Liu, W., Shang, X., Yao, S., & Wang, F. (2019, August 20). A novel and nonderivatization method for the determination of valproic acid in human serum by two‐dimensional liquid chromatography. Retrieved October 17, 2019, at [https://doi.org/10.1002/bmc.4695.“https://doi.org/10.1002/bmc.4695.”].</ref></div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>Several innovations are being investigated for VPA testing. For example, 2D-LC system (two-dimensional chromatography) was studied, allowing large volume injection, reducing interfering components, and reducing the analysis time and preventing most interference components by selecting useful sections in the “heart-cut” column(1D) from entering the analysis column (2D).<ref name=”[11]”>  Liu, W., Shang, X., Yao, S., & Wang, F. (2019, August 20). A novel and nonderivatization method for the determination of valproic acid in human serum by two‐dimensional liquid chromatography. Retrieved October 17, 2019, at [https://doi.org/10.1002/bmc.4695.“https://doi.org/10.1002/bmc.4695.”].</ref></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>. Another example is dried blood spot (DBS) followed by gas chromatography mass spectrometry (GC–MS), which does not require solvent extraction or elution. The limit of quantitation was 200 ng/mL. <ref name=”[12]”> Guo, M., Shao, L., Chen, X., Li, H., Wang, L., Pan, Y., & Tang, D. (2019, September 13). Assay of dried blood spot from finger prick for sodium valproate via ink auxiliary headspace gas chromatography mass spectrometry, Journal of Chromatography A Vol. 1601 p. 335-339. Retrieved October 24, 2019, at [ https://doi.org/10.1016/j.chroma.2019.05.039“ https://doi.org/10.1016/j.chroma.2019.05.039”].</ref></div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>. Another example is dried blood spot (DBS) followed by gas chromatography mass spectrometry (GC–MS), which does not require solvent extraction or elution. The limit of quantitation was 200 ng/mL. <ref name=”[12]”> Guo, M., Shao, L., Chen, X., Li, H., Wang, L., Pan, Y., & Tang, D. (2019, September 13). Assay of dried blood spot from finger prick for sodium valproate via ink auxiliary headspace gas chromatography mass spectrometry, Journal of Chromatography A Vol. 1601 p. 335-339. Retrieved October 24, 2019, at [ https://doi.org/10.1016/j.chroma.2019.05.039“ https://doi.org/10.1016/j.chroma.2019.05.039”].</ref></div></td></tr>
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<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>== References ==</div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>== References ==</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div><references /></div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div><references /></div></td></tr>
</table>Techsensushttps://wiki.sensus.org/index.php?title=Valproate&diff=133&oldid=prevTechsensus: /* Medical use and TDM */2019-12-26T20:10:43Z<p><span dir="auto"><span class="autocomment">Medical use and TDM</span></span></p>
<table class="diff diff-contentalign-left" data-mw="interface">
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<td colspan='2' style="background-color: white; color:black; text-align: center;">← Older revision</td>
<td colspan='2' style="background-color: white; color:black; text-align: center;">Revision as of 20:10, 26 December 2019</td>
</tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l81" >Line 81:</td>
<td colspan="2" class="diff-lineno">Line 81:</td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>The recommended levels of unbound valproate are 6-22 µg/mL in blood <ref name=”[20]”> Valproic Acid (2018, October 1)  , at [https://labtestsonline.org/tests/valproic-acid“https://labtestsonline.org/tests/valproic-acid”].</ref>. For epilepsy patients, the range for the treatment of total valproate should be 50-100 µg/mL. Overall, if a patient has a VPA concentration that falls within this range, does not have recurrent seizures and has minimal side effects, then the dose is said to be suitable<ref name=”[20]”> Valproic Acid (2018, October 1)  , at [https://labtestsonline.org/tests/valproic-acid“https://labtestsonline.org/tests/valproic-acid”].</ref></div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>The recommended levels of unbound valproate are 6-22 µg/mL in blood <ref name=”[20]”> Valproic Acid (2018, October 1)  , at [https://labtestsonline.org/tests/valproic-acid“https://labtestsonline.org/tests/valproic-acid”].</ref>. For epilepsy patients, the range for the treatment of total valproate should be 50-100 µg/mL. Overall, if a patient has a VPA concentration that falls within this range, does not have recurrent seizures and has minimal side effects, then the dose is said to be suitable<ref name=”[20]”> Valproic Acid (2018, October 1)  , at [https://labtestsonline.org/tests/valproic-acid“https://labtestsonline.org/tests/valproic-acid”].</ref></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>. To provide a patient their right amount of medication, therapeutic drug monitoring (TDM) is implemented in hospitals, because every patient responds differently to a certain dose of medication.</div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>. To provide a patient their right amount of medication, therapeutic drug monitoring (TDM) is implemented in hospitals, because every patient responds differently to a certain dose of medication.</div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>VPA is a conventional drug that is used as first line monotherapy for idiopathic generalized epilepsies. Its effectiveness is not clearly conclusive and varies between different patients. The doses are not generalized and depend on patient’s age and weight. Doses are taken every day, with some patients even two times a day. It is not advised, but sometimes necessary, to take VPA in combination with other seizure drugs (e.g., ethosuximide, lamotrigine, phenytoin, rufinamide, topira mate), some antidepressants or certain antibiotics<ref name=”[20]”> Valproic Acid (2018, October 1)  , at [https://labtestsonline.org/tests/valproic-acid“https://labtestsonline.org/tests/valproic-acid”].</ref></div></td><td class='diff-marker'>+</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>VPA is a conventional drug that is used as first line monotherapy for idiopathic generalized epilepsies. Its effectiveness is not clearly conclusive and varies between different patients. The doses are not generalized and depend on patient’s age and weight. Doses are taken every day, with some patients even two times a day. It is not advised, but sometimes necessary, to take VPA in combination with other seizure drugs (e.g., ethosuximide, lamotrigine, phenytoin, rufinamide, topira mate), some antidepressants or certain antibiotics<ref name=”[20]”> Valproic Acid (2018, October 1)  , at [https://labtestsonline.org/tests/valproic-acid“https://labtestsonline.org/tests/valproic-acid”].</ref><ins class="diffchange diffchange-inline">. </ins>Medications based on VPA are harmful for the unborn child. If valproate is taken during pregnancy, research has shown that up to 4 in 10 babies are at risk of developmental disorders, and approximately 1 in 10 are at risk of birth defects. <ref name=”[22]”>  gov.uk. (2018, March 23), at [https://www.gov.uk/guidance/valproate-use-by-women-and-girls“https://www.gov.uk/guidance/valproate-use-by-women-and-girls”].</ref></div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>Medications based on VPA are harmful for the unborn child. If valproate is taken during pregnancy, research has shown that up to 4 in 10 babies are at risk of developmental disorders, and approximately 1 in 10 are at risk of birth defects. <ref name=”[22]”>  gov.uk. (2018, March 23), at [https://www.gov.uk/guidance/valproate-use-by-women-and-girls“https://www.gov.uk/guidance/valproate-use-by-women-and-girls”].</ref></div></td><td colspan="2"> </td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>==Safety & Lab protocols==</div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>==Safety & Lab protocols==</div></td></tr>
</table>Techsensushttps://wiki.sensus.org/index.php?title=Valproate&diff=132&oldid=prevTechsensus: /* Medical use and TDM */2019-12-26T20:09:42Z<p><span dir="auto"><span class="autocomment">Medical use and TDM</span></span></p>
<table class="diff diff-contentalign-left" data-mw="interface">
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<td colspan='2' style="background-color: white; color:black; text-align: center;">← Older revision</td>
<td colspan='2' style="background-color: white; color:black; text-align: center;">Revision as of 20:09, 26 December 2019</td>
</tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l79" >Line 79:</td>
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<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>Testing for valproate levels is important to check if the blood levels are within normal therapeutic range <ref name=”[20]”> Valproic Acid (2018, October 1)  , at [https://labtestsonline.org/tests/valproic-acid“https://labtestsonline.org/tests/valproic-acid”].</ref></div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>Testing for valproate levels is important to check if the blood levels are within normal therapeutic range <ref name=”[20]”> Valproic Acid (2018, October 1)  , at [https://labtestsonline.org/tests/valproic-acid“https://labtestsonline.org/tests/valproic-acid”].</ref></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>. The test should measure  the free concentration (i.e. the concentration of unbound valproate) as this fraction is pharmacologically active.</div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>. The test should measure  the free concentration (i.e. the concentration of unbound valproate) as this fraction is pharmacologically active.</div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>The recommended levels of unbound valproate are 6-22 µg/mL in blood <ref name=”[20]”> Valproic Acid (2018, October 1)  , at [https://labtestsonline.org/tests/valproic-acid“https://labtestsonline.org/tests/valproic-acid”].</ref>.For epilepsy patients, the range for the treatment of total valproate should be 50-100 µg/mL. Overall, if a patient has a VPA concentration that falls within this range, does not have recurrent seizures and has minimal side effects, then the dose is said to be suitable<ref name=”[20]”> Valproic Acid (2018, October 1)  , at [https://labtestsonline.org/tests/valproic-acid“https://labtestsonline.org/tests/valproic-acid”].</ref></div></td><td class='diff-marker'>+</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>The recommended levels of unbound valproate are 6-22 µg/mL in blood <ref name=”[20]”> Valproic Acid (2018, October 1)  , at [https://labtestsonline.org/tests/valproic-acid“https://labtestsonline.org/tests/valproic-acid”].</ref>. For epilepsy patients, the range for the treatment of total valproate should be 50-100 µg/mL. Overall, if a patient has a VPA concentration that falls within this range, does not have recurrent seizures and has minimal side effects, then the dose is said to be suitable<ref name=”[20]”> Valproic Acid (2018, October 1)  , at [https://labtestsonline.org/tests/valproic-acid“https://labtestsonline.org/tests/valproic-acid”].</ref></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>. To provide a patient their right amount of medication, therapeutic drug monitoring (TDM) is implemented in hospitals, because every patient responds differently to a certain dose of medication.</div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>. To provide a patient their right amount of medication, therapeutic drug monitoring (TDM) is implemented in hospitals, because every patient responds differently to a certain dose of medication.</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>VPA is a conventional drug that is used as first line monotherapy for idiopathic generalized epilepsies. Its effectiveness is not clearly conclusive and varies between different patients. The doses are not generalized and depend on patient’s age and weight. Doses are taken every day, with some patients even two times a day. It is not advised, but sometimes necessary, to take VPA in combination with other seizure drugs (e.g., ethosuximide, lamotrigine, phenytoin, rufinamide, topira mate), some antidepressants or certain antibiotics<ref name=”[20]”> Valproic Acid (2018, October 1)  , at [https://labtestsonline.org/tests/valproic-acid“https://labtestsonline.org/tests/valproic-acid”].</ref></div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>VPA is a conventional drug that is used as first line monotherapy for idiopathic generalized epilepsies. Its effectiveness is not clearly conclusive and varies between different patients. The doses are not generalized and depend on patient’s age and weight. Doses are taken every day, with some patients even two times a day. It is not advised, but sometimes necessary, to take VPA in combination with other seizure drugs (e.g., ethosuximide, lamotrigine, phenytoin, rufinamide, topira mate), some antidepressants or certain antibiotics<ref name=”[20]”> Valproic Acid (2018, October 1)  , at [https://labtestsonline.org/tests/valproic-acid“https://labtestsonline.org/tests/valproic-acid”].</ref></div></td></tr>
</table>Techsensushttps://wiki.sensus.org/index.php?title=Valproate&diff=131&oldid=prevTechsensus: /* Pharmacokinetics of VPA */2019-12-26T20:08:01Z<p><span dir="auto"><span class="autocomment">Pharmacokinetics of VPA</span></span></p>
<table class="diff diff-contentalign-left" data-mw="interface">
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<td colspan='2' style="background-color: white; color:black; text-align: center;">Revision as of 20:08, 26 December 2019</td>
</tr><tr><td colspan="2" class="diff-lineno" id="mw-diff-left-l62" >Line 62:</td>
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<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>“https://www.drugbank.ca/drugs/DB00313”].</ref></div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>“https://www.drugbank.ca/drugs/DB00313”].</ref></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>   </div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>   </div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>Only 3% of the drug is eliminated through urine, about 30-50% is eliminated through hepatic metabolism, <del class="diffchange diffchange-inline">as well as </del>about 40% being excreted through mitochondrial-beta oxidation. <ref name=”[18]”> Gugler, R., & Unruh, G. E. von. (2012, December 13). Clinical Pharmacokinetics of Valproic Acid , at [https://link.springer.com/article/10.2165/00003088-198005010-00002 “https://link.springer.com/article/10.2165/00003088-198005010-00002”].</ref></div></td><td class='diff-marker'>+</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>Only 3% of the drug is eliminated through urine, about 30-50% is eliminated through hepatic metabolism, <ins class="diffchange diffchange-inline">and </ins>about 40% being excreted through mitochondrial-beta oxidation. <ref name=”[18]”> Gugler, R., & Unruh, G. E. von. (2012, December 13). Clinical Pharmacokinetics of Valproic Acid , at [https://link.springer.com/article/10.2165/00003088-198005010-00002 “https://link.springer.com/article/10.2165/00003088-198005010-00002”].</ref></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> </div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>===Efficacy and influence on hepatic function===</div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>===Efficacy and influence on hepatic function===</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>Optimal dose and effects are achieved with upper limit of 60 mg/kg/day.  If the desired effects are not achieved (in other words, the seizures are not gone or the side effects are too strong), testing for blood levels of VPA needs to be executed in order to determine whether they fall within the optimal range of total VPA 50-100 µg/mL. Otherwise, the dose is altered in agreement with the doctor according to the individual state of the patient, his/her other conditions or other medication that they take. The toxicity level of valproate in blood, although not very conclusive, is taken as 150 µg/mL<ref name=”[19]”> valproic Acid Dosage Guide with Precautions. (2019, March 28), at [https://www.drugs.com/dosage/valproic-acid.html “https://www.drugs.com/dosage/valproic-acid.html”].</ref></div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>Optimal dose and effects are achieved with upper limit of 60 mg/kg/day.  If the desired effects are not achieved (in other words, the seizures are not gone or the side effects are too strong), testing for blood levels of VPA needs to be executed in order to determine whether they fall within the optimal range of total VPA 50-100 µg/mL. Otherwise, the dose is altered in agreement with the doctor according to the individual state of the patient, his/her other conditions or other medication that they take. The toxicity level of valproate in blood, although not very conclusive, is taken as 150 µg/mL<ref name=”[19]”> valproic Acid Dosage Guide with Precautions. (2019, March 28), at [https://www.drugs.com/dosage/valproic-acid.html “https://www.drugs.com/dosage/valproic-acid.html”].</ref></div></td></tr>
</table>Techsensushttps://wiki.sensus.org/index.php?title=Valproate&diff=130&oldid=prevTechsensus: /* Pathophysiology of epilepsy */2019-12-26T20:05:11Z<p><span dir="auto"><span class="autocomment">Pathophysiology of epilepsy</span></span></p>
<table class="diff diff-contentalign-left" data-mw="interface">
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<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>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></div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>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></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>   </div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>   </div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>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<del class="diffchange diffchange-inline">. The </del>second type is focal seizures with impaired consciousness or change of awareness. <del class="diffchange diffchange-inline">On the other hand, generalized epilepsy types </del>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></div></td><td class='diff-marker'>+</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>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<ins class="diffchange diffchange-inline">; the </ins>second type is focal seizures with impaired consciousness or change of awareness. <ins class="diffchange diffchange-inline">Generalized seizures </ins>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></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>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</div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>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</div></td></tr>
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</table>Techsensushttps://wiki.sensus.org/index.php?title=Valproate&diff=129&oldid=prevTechsensus: /* Pathophysiology of epilepsy */2019-12-26T20:04:01Z<p><span dir="auto"><span class="autocomment">Pathophysiology of epilepsy</span></span></p>
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<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>   </div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>   </div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>   </div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>   </div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div>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></div></td><td class='diff-marker'>+</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>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<ins class="diffchange diffchange-inline">. </ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div> </div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins class="diffchange diffchange-inline">Epileptic seizures appear in two types: focal and generalized</ins>. 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></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>   </div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>   </div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del class="diffchange diffchange-inline">Epileptic seizures appear in two types: focal and generalized. </del>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></div></td><td class='diff-marker'>+</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div>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></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>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</div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>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</div></td></tr>
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</table>Techsensushttps://wiki.sensus.org/index.php?title=Valproate&diff=128&oldid=prevTechsensus: /* Pathophysiology of epilepsy */2019-12-26T20:02:49Z<p><span dir="auto"><span class="autocomment">Pathophysiology of epilepsy</span></span></p>
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<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>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></div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>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></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>   </div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>   </div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;">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></del></div></td><td colspan="2"> </td></tr>
<tr><td class='diff-marker'>−</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;"></del></div></td><td colspan="2"> </td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>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></div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>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></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>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</div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>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</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>“h https://www.ncbi.nlm.nih.gov/pubmed/28276060</div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>“h https://www.ncbi.nlm.nih.gov/pubmed/28276060</div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>”].</ref></div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>”].</ref></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;"></ins></div></td></tr>
<tr><td colspan="2"> </td><td class='diff-marker'>+</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #a3d3ff; vertical-align: top; white-space: pre-wrap;"><div><ins style="font-weight: bold; text-decoration: none;">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></ins></div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>===Valproate Mode of Action===</div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>===Valproate Mode of Action===</div></td></tr>
</table>Techsensushttps://wiki.sensus.org/index.php?title=Valproate&diff=127&oldid=prevTechsensus: /* Mechanism of action */2019-12-26T20:02:01Z<p><span dir="auto"><span class="autocomment">Mechanism of action</span></span></p>
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<td colspan='2' style="background-color: white; color:black; text-align: center;">Revision as of 20:02, 26 December 2019</td>
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<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>   </div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>   </div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>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></div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>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></div></td></tr>
<tr><td class='diff-marker'>−</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;"> </del></div></td><td colspan="2"> </td></tr>
<tr><td class='diff-marker'>−</td><td style="color:black; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #ffe49c; vertical-align: top; white-space: pre-wrap;"><div><del style="font-weight: bold; text-decoration: none;">===Genetic Pathophysiology and Seizure types===</del></div></td><td colspan="2"> </td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>   </div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>   </div></td></tr>
<tr><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>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></div></td><td class='diff-marker'> </td><td style="background-color: #f9f9f9; color: #333333; font-size: 88%; border-style: solid; border-width: 1px 1px 1px 4px; border-radius: 0.33em; border-color: #e6e6e6; vertical-align: top; white-space: pre-wrap;"><div>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></div></td></tr>
</table>Techsensus