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The effect of opiates on epileptic seizures

Publication at Third Faculty of Medicine |
2003

Abstract

Epilepsy is a disease with 0.5-1% prevalence in the Czech Republic. Epileptic seizures may arise primarily, when the cause and the mechanism is probably on the cell or receptor level, or secondarily as a consequence of injury, perinatal trauma, tumor, cerebrovascular bleeding, infection, or metabolic or toxic alterations.

However, the pathogenesis of the primarily generalized seizures is still unclear. Some experimental and clinical studies found that epileptic seizures may be altered or even induced by administration of opiates, such as heroin or morphine.

We demonstrated that the seizure susceptibility may be also affected by prenatal opiate exposure. This suggests that children of mothers, who abused drugs, such as heroin, or were treated with morphine during pregnancy, may have altered seizure threshold and therefore also altered susceptibility to epileptic seizures.

Mechanism of the effect of opiates on epileptic seizures is, however, not yet known. One possible explanation is that opiates alter opioid receptors in brain regions that are responsible for seizure initiation and spread, such as hippocampus and amygdala, or opioid receptors in brain regions controlling seizures, such as substantia nigra, subthalamic nucleus, and superior colliculus.

The effect of opiates on seizures, as well as the effect of opiates on the number and function of opioid receptors in brain regions connected with seizure spread, is sex- and gonadal hormone-dependent.