Role of glutamate and GABA in the pathophysiology of epilepsy

Abstract Epilepsy, a paroxysmal disorder characterized by abnormal neuronal discharges, is common in children. While the causes of epilepsy are many, the fundamental disorder is secondary to abnormal synchronous discharges of a network of neurons. Whether or not a seizure occurs in a child depends upon the balance between excitability and inhibition. Central nervous system neurotransmitters have significant effects on neuronal excitability and play a pivotal role in brain excitability. The most common excitatory neurotransmitter in the brain, glutamate, has been implicated in both the initiation and propagation of seizures as well as brain damage that can occur following prolonged or repeated seizures. Gammaaminobutyric acid, the most common inhibitory neurotransmitter, usually suppresses seizure activity, although in absence seizure drugs that enhance GABA may exacerbate seizures. Experience with GABA indicates that certain neurotransmitters may have either anticonvulsant or proconvulsant effects depending on the neuronal networks involved. While other neurotransmitters also have effects on neuronal excitability, their function in epilepsy remains to be defined. © 1995 Wiley‐Liss, Inc.