
epileptogenisis

oru saadhaarana thalachorinu apasmaram vikasippikkunna kramanugathamaaya prakriyayaan apasmarajanyatha. apasmaram undaakunna oru vittumaaraatha avasthayaanu apasmaram. thalachorilekkulla eee mattangal idaykkide neuronukal asaadhaaranavum hypersynchronous reethiyilum pottitherikkaan kaaranamaakunnu, ithu "sesher" ennariyappedunnu.
kaaranagal.
apasmaarathinte kaaranangale janithaka, gadanaaparamaaya/upapachayam allengil anjjaathamaayi vishaalamaayi tharamthirickunnu. apasmaarathinu kaaranamakunna enthum apasmaarathinu kaaranamaakunnu, kaaranam apasmaram vikasippikkunna prakriyayaan apasmaram. apasmaarathinte gadanaaparamaaya kaaranangalil neuro degenerative rogangal, mastishka parikk, strock, braine tumour, kendra naadeevyavasthayude anubadhakal, staattas apasmaram (deerghakaalathe pidichedukkal allengil pettennulla thudarchayaayi sambhavikkunna pidichedukkalukalude oru parambara) enniva ulppedunnu.
olinjirikkunna kaalayalav.
mastishka parikk sambhavichathinusesham, pidichedukkalukal sambhavikkatha maasangalo varshangalo neendunilkkunna oru "nishabda" allengil "olinjirikkunna kaalayalav" palappozhum undu; kaanadayile neuro sarjan wilder penfield parikkinum pidichedukkalinum edayilulla eee samayathe "vichitramaaya pakamakunna nishabda kaalayalav" ennu vilichu. eee olinjirikkunna kaalayalavil, thalachorinte shareerashaasthrathile mattangal apasmaram vikasippikkunnathin kaaranamaakunnu. hyperrexable neural netvarkkukal roopappedunna eee prakriya epileptogenisis ennu vilikkunnu. gaveshakar apasmaram nannayi manassilaakkukayaanenkil, olinjirikkunna kaalayalav aarogya parirakshaa daathaakkale apasmaarathinte vikaasathil edapedaano athinte theevratha kuraykkaano anuvadichekkaam.
pathophysiology.
apasmaarathinte samayat sambhavikkunna mattangal krithyamaayi manassilakkappettillettim koshangalude maranam, axonal mulaykkal, neural nettvarkkukalude punasamghadana, neuro traansmittarukalude prakaashanatthile mattangal, neurogenesis enniva ulppedunnuvennu karuthappedunnu. eee mattangal neuronukalkku amithamaya swadheenasheshi undaakkukayum swaabhaavikamaaya pidichedukkalukalilekk nayikkukayum cheyyum.
apamaanangalodu valare sensitiivu ayathum apasmaarathinu kaaranamakunnathumaaya mastishka pradeshangalil hippocampus, amigdala, pyriphom courtex thudangiya temporal loob gadanakal ulppedunnu.
neural punasamghadana.
raasa prakriyakalkku purame, thalachorile neuronukalude bhauthika ghadanayil maattam vannekkaam.
manushyarilum mrugangalilum kaivaricha apasmaarathil, pyramid neuronukal nashtappedukayum puthiya synapsukal roopappedukayum cheiyunnu.
neural netvarkkukal sajeevamakaanulla saadhyatha vardhippikkunna apasmaarajanyathayude savishesha savisheshathayaaya hyperexisattabilit, mattu neuronukalude aaveshathe santhulithamaakkunna gabarjik interneuronukal polulla inhibittari neuronukalude nashtam moolamaayirikkaam. apasmaramulla neuronal sarcuteukal hyperexable aayathinum glutamaterjic neuronukaludeyum (saadhaaranayaayi eksaitteshan vardhippikkunnava) gabarjik neuronukaludeyum (athu kuraykkunnava) saadhaarana balance illaathathinum ariyappedunnu. koodaathe, gaabayude alavum neuro traansmittarinodulla gaba resepterukalude samvedanakshamathayum kurayukayum ithu kuranja prathirodhatthinu kaaranamaakukayum cheyyum.
cerebral courtexine phalapradamaayi undercut cheiyunnathiloode velutha dravyathinu kedupaadukal sambhavikkunnath hyperexisattabilitik kaaranamaakunnu ennathaanu tbiyile apasmaarajananathinulla mattoru nirddishta samvidaanam.
glutamate risapttar aaktiveshan.
neuronukalude uparithalathil biochemical resepterukal sajeevamaakkunnath epileptogenisil ulppedunnuvennu vishwasikkappedunnu; ivayil truckby neurotrophene resepterum ionotropic glutamate resepterukalum metabotropic glutamate resepterukalum (ayoon chaanalumayi nerittu bandhappettavayum allaathavayum) ulppedunnu. itharathilulla resepterukalil oronnum sajeevamaakumbol, resepterukal sthithicheyyunna koshatthinte pradeshathu kaalsyam ayonukalude (caa2 +) saandrata vardhikkaan kaaranamakum, koodaathe eee caa2 + nuu src, phine polulla ensaimukale sajeevamakkaan kazhiyum.
neuro traansmittar glutamettinte amithamaya release manushyaril ulppede mastishka parikkin sesham apasmaarathinte oru pradhana bhaagamaayi parakke amgeekarikkappedunnu. glutamate amithamaayi purathuvidunnathu excitotoxisitic kaaranamaakunnu, athil neuronukal amithamaayi depolarise cheyyappedunnu, intra sellular caa 2 + saandrata kuthane vardhikkunnu, koodaathe sellular kedupaadukal allengil marana phalangal undaakunnu. apasmaram vikasichathinusesham amithamaya glutamaterjic pravartthanavum neuronal sarkyoottukalude oru savisheshathayaanu, ennaal olinjirikkunna kaalayalavil apasmaarathil glutamate oru pradhana punk vahikkunnathayi kanunnilla. hyperexitability mattoru gadakathil sii. eiii. 2 + "purathulla" koshangalude saandrata kurayunnu (i.iii. extra sellular spacil) gliel cellukalile atpesinte pravartthanatthil kuravundaakunnu.
rakthathinte mastishka thadassam.
strock, aaghaathakaramaaya mastishka parikk, mastishka anubadha allengil braine tumour thudangiya parikkinu sheshamulla apasmaarathinu kaaranamakunna ellah mastishka shathangaleyum thudarnnu uyarnna vyaapanathilaanu blud braine barrier (bbb) thadassappedunnathu. bbb thadassappedutthal epileptogenisis adivarayidunnathaayi niravadhi pareekshanathmaka modalukal theliyichittundu. koodaathe, serathile ettavum saadhaaranamaaya proteinaaya albumin, bbb thadassappeduthunna saahacharyangalil rakthathil ninnu mastishka parenkaimayilekku chornnolikkunna ejantaanennum aastrosaitukalil parivartthana valarchaa gadakamaaya beetta risapttar sajeevamaakkunnathiloode apasmaarathe prerippikkunnuvennum kaanichu. eee prakriyaykku oru savisheshamaaya koshajwalana paattenum uttejaka sinaapsukalude roopeekaranavum madhyasthatha vahikkunnuvennu adhika anweshanathil velippettu.
hemosiderine allengil irumbu polulla rakthathil janikkunna mattu padaarthangalude puranthallalum rogakaarikalude swaadheenathinu kaaranamaayi. chuvanna rakthaanukkalile oru thanmathrayaaya haemoglobinil ninnulla irumbu kosha stharangale nasippikkunna free raadikkalukalude roopeekaranathilekku nayichekkaam; eee prakriya apasmarajanyathayumaayi bandhappettirikkunnu.
chikitsa.
apasmara gaveshanathinte oru pradhana lakshyam apasmarajanyathaye thadassappeduthunnathino vipareethamaakkunnathino ulla chikilsakal thirichariyuka ennathaanu. mrugangalude modalukalile padanangal saadhyamaaya vaividhyamaarnna aanti epileptogenic thanthrangal nirddeshichittunde, innuvare, klinikkal pareekshanangalil atharam theraappikalonnum aanti epileptogenic aanennu theliyikkappettittilla. levettiraasettam, ethosuximide ennivayulppede chila aanti-konvalsant marunnukal mrugangalude modalukalil mikacha pravartthanam kaanichittundu. vx-765 polulla marunnukal vazhi interlookkin 1β signalling thadayuka; fingolimode polulla marunnukal vazhi sphingosin 1-phoosphett signalling modulation cheyyuka; rapamycin polulla marunnukal vazhi rapamycin (emm. tii. aarr) enna sasthanikalude lakshyam sajeevamaakkuka; erythropoitin enna hormon; vairudhyaparamaayi, α2 adrenergic risapttar aantagast aattipamesol, sibi 1 cannabinoid aantagast sr 141716eiii (remonabant) thudangiya marunnukal proexittettari pravarthanathodoppam.
apasmarajanyathayil tii. jii. eph-beetta sajeevamaakkunna punk kandethiyathode eee signalling thadayunnathu apasmarajanyathaye thadayumenna sidhaantham uyarnnu. raktatimardha chikilsaykkaayi saadhaaranayaayi upayogikkunna marunnaaya losarton apasmaram thadayunnathinum mrugangalude modalukalil bbb rogashanti sugamamakkunnathinum sahaayikkumenn kaanichu. antipyleptogenic ejantumaarude saadhyathakal parishodhikkunnu (udha.jii. losarton) allengil bbb rogashanti marunnukalkk rogikale thiranjedukkunnathinum chikitsa-pholoapinum biomarkerukal aavasyamaanu. bbb distruption imaging mrugangalude maathrkayil apasmaarathinte biomarkeraayi pravarthikkaanulla sheshi kaanikkukayum niravadhi modalukalil apasmaram pravachikkaan nirddishta eeji paattenukal kaanikkukayum cheythu.
charithram.
eee vishayathil rekhaamoolamulla rekhakal nilanilkkunna charithrathiludaneelam, apasmaram oru amanushika prakriyayiloodeyaanu undaayathenn pothuve vishwasikkappettirunnu. medical professionil polum, 18-aamm noottaand vare apasmaarajananathe oru amanushika prathibhaasamenna nilayil upekshikkappettu. ennirunnaalum, jaivaparamaaya vishadeekaranangalum valarekkaalamaayi nilanilkkunnu, chilappol vishadeekaranangalil jaivaparavum amanushikavumaaya gadakangal adangiyirikkunnu.
gaveshanam.
manushya masthishkathil sambhavikkunna epileptogenisis vividha mruga maathrkakalilum koshasamskara maathrkakalilum maathrkayaakkappettundu. apasmaram valare moshamaayi manassilakkappettillathu eee prakriyayekkurichulla vardhichuvarunna dhaarana apasmaram thadayunnathinum apasmaram kandethunnathinum athu thadayunnathinulla chikilsakal vikasippikkunnathinum gaveshakare sahaayichekkam.

