The Hyperexcited Brain: Glutamic Acid Release and Failure of Inhibition

Abstract

There no longer exists much doubt that epilepsy is associated with a rather specific set of biochemical alterations (Delgado-Escueta and Greenberg, 1984). Nevertheless, considerable controversy still surrounds the significance of these alterations, touching on several areas of importance. Perhaps the most crucial issue to be resolved is the question whether the biochemical changes found are in consequence of the cerebral dysfunction or whether, indeed, such alterations contribute directly to the cause of the condition. Traditionally, a diagnosis of epilepsy and its classification to type is most commonly confirmed by electroencephalographic evidence. However, the initial reason for arriving at such a diagnosis is usually occasioned only after an individual has complained of periodic and unpredictable episodes of uncontrollable movements, sensations, vegetative or emotional ‘storms’, or other inappropriate outward expressions of autonomous cerebral activity. Hence, an abnormal or epileptiform EEG activity per se, whether focal or diffuse, in most instances is no cause for a positive and clear diagnosis of epilepsy (Hockaday and Whitty, 1969).