Dry gangrene
Dry gangrene is a form of coagulative necrosis that develops in ischemic tissue, where the blood supply is inadequate to keep tissue viable. It is not a disease itself, but a symptom of other diseases. The term dry is used only when referring to a limb or to the gut (in other locations, this same type of necrosis is called an infarction, such as myocardial infarction). Dry gangrene is often due to peripheral artery disease, but can be due to acute limb ischemia. As a result, people with arteriosclerosis, high cholesterol, diabetes and smokers commonly have dry gangrene. The limited oxygen in the ischemic limb limits putrefaction and bacteria fail to survive. The affected part is dry, shrunken, and dark reddish-black. The line of separation usually brings about complete separation, with eventual falling off of the gangrenous tissue if it is not removed surgically, a process called autoamputation.Dry gangrene is the result of chronic ischemia without infection. If ischemia is detected early, when ischemic wounds rather than gangrene are present, the process can be treated by revascularization (via vascular bypass or angioplasty). However, once gangrene has developed, the affected tissues are not salvageable. Because dry gangrene is not accompanied by infection, it is not as emergent as gas gangrene or wet gangrene, both of which have a risk of sepsis.
VPA also has a wide range of side effects, like high-frequency tremor, altered mental status, increased appetite and weight gain, pancreatitis, and hepatic failure, thrombocytopenia, teratogenesis during pregnancy, although serious side effects are rare and usually dose-dependent. Usual maintenance dose in children is 20–30 mg/kg/day. Lamotrigine (LTG) could be can be used as alternative add-on treatment for CAE along with VPA and ETX. Other possible treatments in the rare cases of pharmacoresistant include levetiracetam, clobazam, topiramate, zonisamide. Epidemiology
The occurrence of absence seizures varies from 0.7 to 4.6/100,000 in the overall population and from 6 to 8/100,000 in children up to 15 years old. There is some evidence showing that girls are more frequently affected by CAE than boys. See also
Generalized epilepsy with febrile seizures plus
Calcium channel
Spike and Wave

References
Perez-Reyes E (2006). "Molecular characterization of T-type calcium channels". Cell Calcium. 40 (2): 89–96. doi:10.1016/j.ceca.2006.04.012. PMID 16759699. Footnotes


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