RECENT UPDATES IN EPILEPSY THERAPY

Abstract

E pilepsy is one of the most common serious neurological disorders affecting about 65 million people globally. It affects 1% of the population by age 20 and 3% of the population by age 75.It is more common in males than females with the overall difference being small. Most of those with the disease (80%) are in the developing world . Epilepsy is not necessarily life-long, and is considered to be resolved if a person has been seizure-free for the last 10 years, with at least the last 5 year off ant seizure medicines, or when that person has passed the age of an age-dependent epilepsy syndrome. Studies providing detailed knowledge of seizure recurrence risk are few, so most diagnoses of epilepsy will of necessity still be made by documentation of two unprovoked seizures so epilepsy can be defined by any of the following conditions: 1. At least two unprovoked (or reflex) seizures occurring >24 h apart. 2. One unprovoked (or reflex) seizure and a probability of further seizures similar to the general recurrence risk (at least 60%) after two unprovoked seizures, occurring over the next 10 years. 3. Diagnosis of an epilepsy syndrome. Epilepsy has many classification some of them classify seizuresaccording to their phenomenological origin, types and conscious level and others classify according to age and severity beside the classification of epilepsy syndromes. There are a lot of theories to explain causes of epilepsy which is most probably amulti-theoritical disease.there is the theory of Neurotransmitters which depends mainly on the excess glutamate which is the most stimulatory neurotransmitter and decreased GABA which is the most inhibitory neurotransmitter in brain.there is also disturbed sodium, potassium and calcium channel function beside autoimmune theory , tropical and inflammatory causes which depend on infection and finally hormonal disturbance and its role in epilepsy. Diagnosis of epilepsy is a collaperative clinical issue depending on clinical and investigation measures so the first thing to do is the assessment of mental state which is very important although frequently underrated. The testing of electrolyte, blood glucose and calcium levels is important to rule out problems with these as causes.An electrocardiogram can rule out problems with the rhythm of the heart. A lumbar puncture may be useful to diagnose a central nervous system infection but is not routinely needed. In children additional tests may be required such as urine biochemistry and blood testing looking for metabolic disorders. Electroencephalography has played crucial role in diagnosis of epilepsy. Electroencephalography is greatly improved as a reliable method of diagnosis.