23rd International Conference on Neurology & Neurophysiology
Euro Akademie Pößneck, Germany
Title: Update of the neural networks involved in generalized epilepsy
Biography: Felix-Martin Werner
We reviewed the alterations of neurotransmitters and neuropeptides in the following brain areas involved in generalized epilepsy: hippocampus, hypothalamus, thalamus and cerebral cortex. In these brain areas, neural networks are also actualized. The mechanisms of action of newer antiepileptic drugs, for example a GABAB agonist, an AMPA receptor antagonist and brivaracetam, used in the treatment of generalized epilepsy are also discussed. Updating the neural networks, we suggest that in the hippocampus GABAergic neurons presynaptically inhibit, via GABAB receptors, epileptogenic neurons. GABAergic, glutamatergic, serotonergic and dopaminergic neurons form the principal neural network, while GABA and serotonin deficiency and dopamine and glutamate hyperactivity have a proconvulsant effect. In preclinical studies, the GABAB receptor agonist GS-39,783 exerted a good antiepileptic effect. Perampanel, an AMPA receptor antagonist, showed good anticonvulsant effects in the treatment of partial-onset seizures and primary generalized tonic-clonic seizures. In this treatment, perampanel can be combined with other antiepileptic drugs. Brivaracetam, whose mechanism of action will be explained in detail, showed a good efficacy in the treatment of adult focal seizures and secondarily generalized tonic-clonic seizures.