Epilepsy

Epilepsy is the tendency to have seizures on a chronic, recurrent basis. This implies that there is a permanent change in cortical function which renders neurons more likely to participate in a seizure discharge. This process is referred to as epileptogenes-is, and the exact way in which it occurs is not known. A process thought to be similar to epileptogenesis in humans occurs after prolonged, intermittent electrical stimulation of animal brains and is known as kindling. Epilepsy may develop days, months, or many years after an insult to the cortex. It may be that an originally small group of abnormal neurons causes adjacent or connected neurons to gradually become abnormal as well, by bombarding them over time with frequent, repeated electrical impulses. When the network of abnormal neurons becomes sufficiently large, it becomes capable of sustaining an excessive firing pattern for at least several seconds: a seizure. This hyperexcitable network of neurons is then the seizure focus.

If the change in cortical electrical characteristics is permanent, why don't seizures occur all the time? This is probably because the occurrence of an individual seizure depends upon an interplay of environmental and internal brain factors that, from time to time, result in loss of the normal mechanisms that contain and control abnormal neuronal firing. Some common factors are sleep loss and fatigue, but it is impossible to determine what sets off a particular seizure in most patients.

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