Possible new neurochemical mechanisms of epilepsy

A.S. Kharibegashvili, S.K. Yevtushenko, M.F. Ivanova

Abstract


In the article, the authors offer a supplement to the hypothesis about the pathogenesis of epilepsy previously published by A.S. Kharibegashvili and G.I. Chachia. According to the hypothesis, in epileptic patients epileptogenic substances are permanently accumulating in the brain, which in the course of epileptic activity in the brain undergo metabolic changes requiring their removal from the organism. When the concentration of epileptogenic substances in brain reaches a threshold value, they cause a seizure, and in lower concentrations they cause epileptic activity typical for interictal period. In the context of this hypothesis, there are discussed the clinical signs of the epilepsy such as forced normalization, reinforcement epilepsy activity during the sleep deprivation and one of the paradoxical effect of antiepileptic drugs such as phenomenon when antiepileptic drugs prescribed cause an improvement of the electroencephalographic image but the clinical deterioration and increasing frequency of seizures, and the change of antiepileptic drugs gives us the opposite results: improvement of the clinical picture and the deterioration of electroencephalographic image. According to the supplemented hypothesis, epileptogenic substances, except that, during epileptic activity in the brain undergo metabolic transformations required their removal from the body; there are also alternative transformation neurochemical pathways necessary for further removal (elimination) from the organism. The hypothesis discusses the modern principles of the epilepsy treatment. Forced normalization is considered as one of the manifestations of epilepsy aggravation. The authors proposes to call the phenomenon “clinical-electroencephalographic dissociation” when the anti-epileptic drugs is associated with improved electroencephalographic pattern, but with the deterioration of the clinic and frequent seizures, and the drug change leads to the opposite — the improvement of the clinical picture and the EEG deterioration.


Keywords


epilepsy; neuromediator; forced normalization of electroencephalogram image; aggravation; hypothesis

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DOI: https://doi.org/10.22141/2224-0713.2.88.2017.100192

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