Lyrica

Active ingredient: Pregabalin

Pregabalin is a medication used world-wide in the treatment of partial onset seizures, postherpetic neuralgia, diabetic neuropathy, fibromyalgia, spinal cord injury neuropathic pain, and generalized anxiety disorder. The actions of pregabalin are mediated through binding with high affinity to alpha-2-delta proteins, which attenuates calcium influx into presynaptic neurons and thereby blocks the release of neurotransmitters, including the excitatory neurotransmitter l-glutamate.

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What is Epilepsy

Epilepsy affects up to 1% of the population, making it second to stroke as one of the most common serious neurologic disorders. About 50 million people world wide have epilepsy and 90% of them are from developing countries. In the past several years, our understanding of epilepsy has increased in several respects. It is a common chronic neurological disorder in which the balance between cerebral excitability and inhibition is tipped toward uncontrolled excitability and characterized by recurrent unprovoked 3-5 seizures. There is now clear evidence that there are distinct differences between the immature and mature brain in the pathophysiology and consequences of seizures. It is a collection of many different types of seizures that vary widely in severity, appearance, cause, consequence and management.

Epilepsy is a common medical and social disorder or group of disorders with unique characteristics. Epilepsy is usually defined as a tendency to recurrent seizures. The word "epilepsy" is derived from Latin and Greek words for "seizure" or "to seize upon". This implies that epilepsy is an ancient disorder; indeed, in all civilizations it can be traced as far back as medical records exist. In fact, epilepsy is a disorder that can occur in all mammalian species, probably more frequently as brains have become more complex. Epilepsy is also remarkably uniformly distributed around the world.
There are no racial, geographical or social class boundaries. It occurs in both sexes, at all ages, especially in childhood, adolescence and increasingly in ageing populations.

Causes of epilepsy

The cause of epilepsy is completely unknown. The word epilepsy does not indicate anything about the cause or severity of the person's seizures, some cases of epilepsy are induced by genetic factors, but it can also result form brain injuries caused by blows to 19 the head, stroke, infections, high fever or tumors. It has been observed that heredity (genetics) play an important role in many causes of epilepsy in very young children, but it can be a factor for people of any age. For instances, not everyone who has a serious head injury (a clear cause of seizures) will develop epilepsy.

There are different causes of epilepsy that are common in different age groups;

• 1. In neonatal period and early infancy, the most common causes are hypoxic–ischemic encephalopathy, CNS infections, trauma, congenital CNS abnormalities and metabolic disorder.
• 2. In late infancy and early childhood, the most common febrile seizures may be caused by CNS infections and trauma.
• 3. In child hood well defined epilepsy syndromes are generally observed.
• 4. In adolescence and adult hood the causes are more likely to be secondary to any CNS lesion.
• 5. In old persons, cerebrovascular disease is the most common cause, the other causes, includes CNS tumors, head trauma and 22 other degenerative diseases like dementia.

Symptoms of seizure

The seizure is the characteristic event in epilepsy associated with the episodic high frequency discharge of impulses by a group of neurons in the brain. The clinical signs and symptoms of seizure depend on the location of the epileptic discharges in the cortex and the extent and pattern of the propagation of the epileptic discharge in the brain. e.g. involvement of the motor cortex causes convulsions, hypothalamus causes peripheral autonomic discharge and the involvement of the reticular formation of the upper brain stem leads to the loss of consciousness.

Seizure type and epilepsy syndrome

Generalized seizures are common in field studies, especially in developing countries, often because partial seizures are missed. In developed countries, over half the incidence cases are partial. Partial and generalized seizures vary with age, partial seizures being more common in the very young and in elderly people. Generalized tonic–clonic seizures occur uniformly throughout the life-course; absence seizures occur maximally between 5 and 10 years of age; and myoclonic seizures in the under-five-year-olds and around 15 years. Idiopathic epilepsy is usually seen in the young, and remote symptomatic epilepsy at the extremes. In developing countries, however, symptomatic epilepsy caused by infections should be considered at any age.

Diagnosis by syndrome is important for prognosis and treatment. For example, a cryptogenic/symptomatic localization syndrome, the commonest paediatric syndrome, is likely to be caused by a brain lesion which may be amenable to surgery if seizures are medically uncontrollable. Childhood absence epilepsy, the commonest idiopathic generalized epilepsy, whose prognosis is poor if untreated and excellent if treated, may be missed altogether in population screening.

Management of Epilepsy

The terms anticonvulsant and antiepileptic are used inter changeably. An anticonvulsant is an agent that blocks experimentally produced seizures in laboratory animals and antiepileptic drug is a drug used medically to control the epilepsies such as Lyrica (Pregabalin).