How is Levetiracetam thought to control focal seizures?
Levetiracetam is an antiepileptic drug (AED) used in the treatment of focal seizures. It is available as a brand medication, Keppra, and in generic form. Levetiracetam is thought to control focal seizures through several mechanisms:
1. Inhibition of synaptic vesicle protein SV2A: Levetiracetam binds to synaptic vesicle protein 2A (SV2A), which is involved in the release of neurotransmitters from the presynaptic neuron. By binding to SV2A, Levetiracetam decreases the release of excitatory neurotransmitters, such as glutamate and aspartate. This reduction in excitatory neurotransmission helps to control the abnormal electrical activity in the brain that can lead to seizures.
2. Enhancement of GABAergic transmission: Levetiracetam also potentiates the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) by increasing the sensitivity of GABA receptors. This enhancement of GABAergic transmission helps to suppress neuronal excitability and prevent the spread of seizures.
3. Modulation of voltage-gated ion channels: Levetiracetam has been found to modulate the function of voltage-gated ion channels, particularly N-type and P/Q-type calcium channels and potassium channels. By modifying the activity of these ion channels, Levetiracetam can stabilize neuronal membranes, reduce the influx of calcium ions into neurons, and further suppress seizure activity.
4. Other mechanisms: In addition to the main mechanisms described above, Levetiracetam may also exert anti-seizure effects through other mechanisms, including altering the activity of other neurotransmitter systems, such as the serotonergic and dopaminergic systems. Further research is needed to fully understand all the mechanisms of action of Levetiracetam.
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