The Science of Epilepsy

The human brain is the source of human epilepsy. Although the symptoms of a seizure may affect any part of the body, the electrical events that produce the symptoms occur in the brain. The location of that event, the extent of its reach within the tissue of the brain, and how long it lasts all have profound effects. These three factors determine the character of the seizure, its impact on the individual, and the social consequences involved.

Epilepsy & The Brain

Seizure Mechanisms

A seizure is a massive disruption of electrical communication between neurons in the brain, leading to the temporary release of excessive energy in a synchronized form. Neurons communicate with each other by firing electrical impulses. These impulses travel from the neuron along the axon, and then stimulate the release of neurotransmitters which flow across the synaptic cleft (the gap between the cells) to the dendrites of the receiving cell.

If more excitatory than inhibitory transmitters are released, the cell will fire; if more inhibitory neurotransmitters are released, the cell will not fire. Since large numbers of cells are involved in even simple actions, the on/off action serves to control physical and mental functioning.

However, if there is a consistently higher level of the excitory neurotransmitters, or too few inhibitory ones, the likelihood of a seizure—an uncontrolled, continuing firing of neurons in the brain—is increased. Some of the newer medications relate directly to this process and are designed to increase the level of inhibitory neurotransmitters, especially gamma-aminobutyric acid (GABA), or to decrease the amount of the excitatory ones, such as glutamate.

A sudden burst of neuronal firing may not be sufficient to cause an obvious seizure (although it might show up as a sudden spike on the EEG); however, if the discharge of electrical energy has sufficient power and affects enough neurons, it will produce symptoms characteristic of the area in which the discharge took place. The result could be a sudden muscle jerk, an abrupt fall, a distorted vision. If the disturbance flashes across the whole brain at once, it could produce a convulsive seizure, temporarily disrupting many of the functions of the brain.

Seizure Threshold

This concept holds that everyone has a certain balance (probably genetically determined) between excitatory and inhibitory forces in the brain. The relative proportions of each determine whether a person has a low threshold for seizures (because of the higher excitatory balance) or a high threshold (because of greater inhibition). According to this view, a low seizure threshold makes it easier for epilepsy to develop, and easier for someone to experience a single seizure.

HOW THE BRAIN WORKS

Structure

The brain is divided into parts, some overlaying one another in the order in which they have evolved. Any review of epilepsy begins with a brief description of brain geography and function.

Hemispheres

Each hemisphere of the brain has four distinct sections, or lobes. These are the frontal, parietal, temporal and occipital lobes.

Brain Functions & Makeup

While distinct areas of the brain are associated with distinct functions, it is also true that the brain works through a network of connections and interrelated parts.