title: Low-grade chronic metabolic acidosis is a contributory mechanism in the development of chronic epilepsy.
abstract: In most people with epilepsy, the condition is readily controlled, but 20-30% develop chronic epilepsy. An estimated 80,000 patients with epilepsy require ongoing specialist care in the United Kingdom. Nutrition may be a factor in the development of chronic epilepsy. Modern Western diets are thought to produce a low-grade chronic metabolic acidosis. The hydrogen ion, H+, is a potent modulator of NMDA-activated currents, and in cultured neurons, increased external [H+] strongly suppresses these currents. The effect of chronic metabolic acidosis in vivo has not been fully studied. It is possible that low-grade chronic metabolic acidosis chronically inhibits the NMDA-activated currents, and this may lead to upregulation of the NMDA receptor. This would result in a greater hyperexcitable state and may contribute to the development of chronic epilepsy.
authors.affiliation: Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK. alan@yuen.freeserve.co.uk
authors.forename: Alan W C
authors.initials: AW
authors.lastname: Yuen
mesh_terms: D000138:Acidosis / Q000150:complications* / Q000378:metabolism; D000927:Anticonvulsants / Q000627:therapeutic use*; D001921:Brain / Q000378:metabolism; D002257:Carbonic Anhydrase Inhibitors / Q000627:therapeutic use*; D002908:Chronic Disease; D004032:Diet / Q000009:adverse effects; D004827:Epilepsy / Q000178:diet therapy / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D007662:Ketosis / Q000378:metabolism; D016194:Receptors, N-Methyl-D-Aspartate / Q000378:metabolism
chemical_list: D000927:Anticonvulsants; D002257:Carbonic Anhydrase Inhibitors; D016194:Receptors, N-Methyl-D-Aspartate