DSSSB 14 August 2024
Medical & Surgical Nursing
Medium
The neurotransmitter abnormality commonly associated with epilepsy is:
Appeared in: DSSSB 14 August 2024
Explanation
- Gamma-aminobutyric acid (GABA) is the primary inhibitory neurotransmitter in the central nervous system, acting as a 'brake' to calm neuronal activity.
- Epilepsy is fundamentally a disorder of neuronal hyperexcitability.
- A low level of GABA, or decreased function of its receptors, removes this essential inhibitory control, allowing neurons to fire excessively and synchronously, which results in a seizure.
- Many antiepileptic drugs, such as benzodiazepines and valproic acid, work by enhancing the effects of GABA to restore the inhibitory balance.
Why Other Options Were Wrong
- Option A: Epinephrine is primarily a hormone and neurotransmitter for the sympathetic nervous system ('fight or flight' response). Its levels are not the direct underlying cause of the neuronal imbalance in epilepsy.
- Option B: Similar to low levels, high levels of epinephrine are not the root cause of epilepsy. While a surge in epinephrine due to stress can be a seizure trigger for some, it is not the core neurochemical defect.
- Option D: A high level of GABA would cause excessive inhibition of the central nervous system. This would lead to sedation, lethargy, or even coma, which is the opposite of the hyperexcitability seen in seizures.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Neurochemical basis of epilepsy as background academic context rather than a clinical decision trigger.
- Understanding the role of GABA is crucial for nurses, as many antiepileptic drugs (e.g., benzodiazepines, barbiturates, valproic acid) work by enhancing GABA's inhibitory effects.
- Nurses must monitor patients for signs of both seizure activity (indicating insufficient inhibition) and excessive sedation or respiratory depression (indicating over-inhibition from medication).
- Patient education should include the importance of medication adherence to maintain the proper neurochemical balance and prevent seizures.
How to Approach the Question
- First, identify the core concept of the question: the neurochemical cause of epilepsy.
- Recall the basic principle of brain activity: it requires a delicate balance between excitation ('go' signals) and inhibition ('stop' signals).
- Recognize that epilepsy is a condition of excessive excitation or 'hyper-synchronous' firing of neurons.
- Identify the brain's primary inhibitory (brake) neurotransmitter, which is GABA, and the primary excitatory (accelerator) neurotransmitter, which is Glutamate.
- Reason that a state of hyperexcitability (seizure) must be caused by either too little inhibition or too much excitation.
- Evaluate the options: A 'low level of GABA' means the brain's primary braking system is failing, which directly explains the hyperexcitability of epilepsy.
Concept Tested & Keywords
- Concept Tested: Neurochemical basis of epilepsy
- Stem keywords: neurotransmitter abnormality, epilepsy
- Lead-in keywords: commonly associated with
Question ID
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Reference Book
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) pp. 3026-3028, 1316-1318
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 418-420
Practise the full DSSSB 14 August 2024
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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