Epilepsy is one of the most common neurological problems worldwide. Estimates indicate that approximately 2 million people in the United States have epilepsy and that 3 % of the general population will suffer epilepsy in any given period of their life. In general, epilepsy is the excessive expression of neuronal excitability, commonly associated with inhibitory activity deficit. There are two predominant neuronal groups in the central nervous system:
- The main neurons, also known as excitatory neurons, which use the neurotransmitter glutamate
- The interneurons, which use the neurotransmitter GABA and have inhibitory activity.
Imbalance between both neuronal groups generates multiple diseases, epilepsy among them, where the excitatory activity is excessive and the inhibitory or gabaergic activity is deficient.
The most common causes can be a deficient formation of gabaergic neurons or their loss in certain events, like head trauma, hypoxia (lack of oxygen), ischemia (loss of blood circulation), neuroinfections (like encephalitis), brain tumors, cysticercosis, among others.
Another group of epilepsies shows genetic disorders that affect the development of connections and activity of excitatory neurons, resulting in aberrant connections, excessive activity, and ultimately, epilepsy.
Neurophysiological studies, like the electroencephalogram and event-related potentials are essential to detect the areas affected by this imbalance.
In general, the current treatments increase the inhibitory or gabaergic activity, but do not solve the problem completely because they do not improve the imbalance between excitatory and inhibitory neurons, which should be the priority objective.