calcium influx

Introduction

Introduction Calcium can regulate numerous cellular biological processes by activating calmodulin; calmodulin is an important calcium-binding protein in the human body. As a receptor for calcium ions, it is a medium that assists calcium ions in accomplishing various physiological functions. The relationship between calcium ions and seizures has been clarified, and calcium ion intracellular flow is the basic condition for the onset of epilepsy. Many causes of this disease can cause epilepsy, especially in the cerebral cortex. Epilepsy is prevalent in a family of patients with a history of epilepsy or a congenital central nervous system or cardiac malformation.

Cause

Cause

There are many reasons for epilepsy, especially in the cerebral cortex. It is generally considered to be related to the following four factors:

1. Genetic factors: Epilepsy is prone to occur in a family of patients with a history of epilepsy or a congenital central nervous system or cardiac malformation.

2, brain damage and brain damage: embryonic development caused by viral infection, radiation exposure or other causes of embryonic dysplasia can cause epilepsy; fetal production, the birth injury is also a major cause of epilepsy; craniocerebral trauma can also Causes epilepsy.

3, other diseases of the brain: brain tumors, cerebrovascular diseases, intracranial infections.

4. Environmental factors: Male patients are slightly more than female patients, and the incidence rate in rural areas is higher than that in cities. In addition, fever and mental stimulation are also the causes of epilepsy.

Examine

an examination

Related inspection

Serum calcium cerebrospinal fluid calcium

Clinical manifestations:

According to the type of clinical attack:

First, generalized tonic - clonic seizures (big episodes):

Suddenly, consciousness is lost, followed by a strong temperament. Often accompanied by screaming, complexion bruising, urinary incontinence, tongue bite, foaming or foaming at the mouth, dilated pupils. After a tens of seconds or minutes, the seizure naturally stops and enters a state of drowsiness. After waking up, there is a short period of dizziness, irritability, and fatigue, which cannot be recalled during the attack. If the episode continues, those who have been in a coma state say that the episode is in a state of constant attack and often endangers life.

Second, absence of seizures (small episodes):

Sudden mental activity is interrupted, loss of consciousness, may be associated with myoclonus or autonomic syndrome. A seizure of a few seconds to more than ten seconds. EEG appears 3 times / sec slow or sharp slow wave synthesis.

Third, a simple partial seizure:

A local or one-sided limb with a stiff, clonic attack, or a paroxysmal episode, which is short-lived and clear-minded. If the range of attack extends to other limbs or the whole body along the movement, it can be associated with loss of consciousness. It is called Jack. After the attack, the affected limb may have temporary paralysis, called Todd paralysis.

Fourth, complex partial seizures (psychomotor episodes):

Psychosensory, psychomotor, and mixed seizures. There are varying degrees of disturbance of consciousness and obvious mental, sensory, emotional and psychomotor disorders. There may be autopsy symptoms such as snoring and night snoring. Sometimes, under the control of hallucinations and delusions, violent acts such as wounding and self-injury can occur.

5. Autonomic seizures (diencephalic):

There may be headache type, abdominal pain type, limb pain type, syncope type or cardiovascular attack.

Those with no clear cause are primary epilepsy, secondary to intracranial tumors, trauma, infection, parasitic diseases, cerebrovascular diseases, systemic metabolic diseases, etc. are secondary epilepsy.

Epilepsy auxiliary examination:

1. EEG, BEAM, Holter (EEG, EEG topographic map, dynamic EEG monitoring): visible pathological waves, spikes, spikes, spines-slow waves or sharp-slow waves.

2. If secondary epilepsy should be further examined by head CT, head MRI, MRA, DSA, etc., the corresponding lesions can be found.

3. Epilepsy and biochemistry: Epilepsy is closely related to various chemical substances in the human body. Neurobiochemistry plays an important role in elucidating the pathogenesis of epilepsy at the molecular level.

First, the biochemical changes in the brain during the attack:

(1) Seizures are often accompanied by abnormal changes in arterial oxygen partial pressure, arterial carbon dioxide partial pressure, blood sugar, non-lipidated fatty acids, ATP, chromium, phosphorus, glutamate, glutamine, lactate, GABA, and the like.

(2) When the seizure occurs, the oxygen demand increases, the glucose metabolism accelerates, the concentration of creatinine in the brain decreases, and the concentration of creatine increases.

(3) The serotonin decreased, the dopamine content decreased, and the cholinesterase activity increased in the brain during seizures.

Second, the brain energy state and metabolic reserve during the attack:

At the beginning of the attack, the glucose content of the brain decreased rapidly, and the glycogen returned to normal two hours later. This is associated with an increase in plasma insulin concentration during seizures. In the first few seconds of epileptic seizures, the creatine concentration increases and the phosphocreatine concentration decreases. ATP concentration decreases when hypoxia, arterial hypotension, or hypoglycemia occurs.

Third, epilepsy and monoamine transmitters:

Monoamine-based transmitters include serotonin, dopamine, epinephrine, acetylcholine, etc., and the brain has a decrease in serotonin, a decrease in dopamine content, and an increase in cholinesterase activity during seizures.

4. Epilepsy and amino acid transmitters:

Amino acid transmitters include GABA, Glu, ASP, Gly, Ala, Tau. Among them, GABA is the main inhibitory transmitter in the brain, while glutamate is the main excitatory transmitter in the brain.

5. Epilepsy and Cyclic Nucleotides:

Cyclic nucleotides include cyclic adenosine monophosphate (CAMP) and cyclic guanosine monophosphate (CGMP), which are "second messengers" of central nervous cells and play an important regulatory role in central nervous system activity.

6. Epilepsy and neuropeptides:

Neuropeptides are a class of compounds that are linked by dozens of low molecular weight single chain amino acids. It is involved in the pathogenesis of epilepsy.

Seven, epilepsy and calcium ions and calmodulin:

Calcium can regulate numerous cellular biological processes by activating calmodulin; calmodulin is an important calcium-binding protein in the human body. As a receptor for calcium ions, it is a medium that assists calcium ions in accomplishing various physiological functions.

The relationship between calcium ions and seizures has been clarified, and calcium ion intracellular flow is the basic condition for the onset of epilepsy.

Studying the relationship between epilepsy and biochemistry is of great significance for opening up new methods and new ways to treat epilepsy.

Diagnosis

Differential diagnosis

Should be identified with syncope, pseudo seizures, narcolepsy, hypoglycemia. According to EEG, medical history, symptoms and signs are not difficult to identify.

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