Use of Levetiracetam in the Treatment of Epileptic Seizures

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Introduction
Epilepsy is a serious global problem that affects approximately 1% of people worldwide (1). Epilepsy is a chronic condition of the central nervous system (CNS) characterized by epileptic seizures, which can affect physical and mental functions (2). Epileptic seizures are unprovoked reoccurring episodes of abnormal, excessive, or hypersynchronis neuronal activity in the CNS (2). The treatment options of epilepsy include medications called antiepileptic drugs (AED) and surgeries based on individuals’ specific diagnosis and background (1). The AED Keppra®, S-enantiomer of α-ethyl-2-oxo-1-pyrrolidine acetamide, or Levetiracetam (LEV) is Food and Drug Administration (FDA)-approved for the treatment and prevention of epileptic
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The ability of HVA Ca2+ channels to alter the firing pattern of postsynaptic neurons makes regulation of HVA Ca2+ channels a means to help prevent hypersynchronis neuronal activity and prevent epileptic seizures. The synaptic vesicle protein 2A (SV2A) is a protein in neurons that is important for calcium-regulated secretion of neurotransmitters (6). The protein SV2A regulates neurotransmitter release by affecting the expression of the Ca2+ sensor protein synaptotagmin, by reducing Ca2+-mediated vesicle exocytosis and thereby reducing neurotransmitter release (6). The ability of SV2A to affect synaptotagmin expression and reduce exocytosis makes regulation of SV2A binding a means to prevent abnormal neuronal activity and prevent epileptic seizures.
The ryanodine receptors (RyRs) are intracellular Ca2+ channels that are a cellular mediator for calcium-induced calcium release (CICR) (1). The inositol 1,4,5-triphosphate receptors (IP3R) are intracellular Ca2+ channels that act as a cellular mediator for CICR through their activation of a second messenger that causes the release of Ca2+ (1). In the process of CICR Ca2+ is released from intracellular storage (3). In the development of epilepsy, a dysregulation of intracellular calcium ([Ca2+] i) by inositol 1,4,5-triphosphate receptors (IP3R) and ryanodine receptors (RyR)
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