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content:absence_seizures [2024/03/09 17:15] – created biju.hameed@gmail.com | content:absence_seizures [2024/03/09 17:46] (current) – biju.hameed@gmail.com | ||
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Absence seizures are short seizures with behavioural arrest and generalised 3-Hertz spike-and-wave discharges on EEG. Absence seizures occur in multiple genetic generalized epilepsies, including [[childhood absence epilepsy]] (CAE), [[juvenile absence epilepsy]] (JAE), and [[juvenile myoclonic epilepsy]] (JME). | Absence seizures are short seizures with behavioural arrest and generalised 3-Hertz spike-and-wave discharges on EEG. Absence seizures occur in multiple genetic generalized epilepsies, including [[childhood absence epilepsy]] (CAE), [[juvenile absence epilepsy]] (JAE), and [[juvenile myoclonic epilepsy]] (JME). | ||
===== Pathophysiology ===== | ===== Pathophysiology ===== | ||
- | The pathogenesis involves the cortico-thalamic-cortical circuit[(: | + | < |
- | Excitatory thalamic relay neurons connect to cortical pyramidal neurons.Inhibitory GABA-ergic projections from thalamic nucleus reticularis neurons connect with other neurons and thalamic relay neurons, but not with the cortex. | + | * The pathogenesis |
+ | * Glutamatergic | ||
+ | | ||
+ | * The thalamic nucleus reticularis' | ||
+ | * Spikes in thalamocortical networks and thalamic nucleus reticularis neurons influence these firing patterns | ||
+ | * Inhibitory GABA-ergic projections from thalamic nucleus reticularis neurons connect with other neurons and thalamic relay neurons, but not with the cortex. | ||
+ | * An aberrant oscillatory rhythm can result from T-type channel defects or enhanced GABA-B activity. T-type calcium channels act as low-threshold transient calcium channels. After depolarization, | ||
- | The thalamic nucleus reticularis' | + | Hence T-type calcium channel suppressors like ethosuximide and valproate are used for treating absence seizures. GABA-A agonists like benzodiazepines that preferentially activate thalamic nucleus reticularis neurons can also decrease absence seizures. However Vigabatrin, which increases GABA-B activity will increase absence seizures. Other medications which can worsen absence seizures are sodium channel blockers like Carbamazepine, |
- | + | ||
- | Hence T-type calcium channel suppressors like ethosuximide and valproate are used for treating absence seizures. GABA-A agonists like benzodiazepines that preferentially activate thalamic nucleus reticularis neurons can also decrease absence seizures. However Vigabatrin, which increases GABA-B activity will increase absence seizures. | + | |
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