Epilepsy: Mental Illness with Multiple Causes

By Frank Amthor

Epilepsy is characterized by seizures in the brain. Seizures are incidents of hyper-synchronous neural activity during which normal, controlled brain function is severely compromised. Epilepsy has multiple causes, ranging from genetic to developmental abnormalities that may have environmental contributions. Treatments for epilepsy include

  • Pharmaceuticals: Drugs used to treat epilepsy are called anticonvulsants; currently, 20 are approved by the FDA. Most of these are aimed at increasing GABA transmission (GABA is the most important and ubiquitous fast inhibitory neurotransmitter in the brain). About 70 percent of patients experience a reduction of seizures with one or more of these drugs — which leaves about 30 percent of epileptics with no improvement from any approved drug. Most anticonvulsants also have significant side effects.
  • Surgery: Surgery is the major treatment possibility for patients whose seizures cannot be controlled by drugs or who cannot tolerate the side effects. In epilepsy surgery, the surgical team attempts to locate the focus of the seizure, which is the damaged area of the brain where the seizure usually starts, and remove it. Surgery is very effective where the seizure focus can be located and removed, but there are many cases in which this is not possible.

The search continues for better drugs and better imaging techniques to locate where and how seizures originate.