So what can we conclude--do seizures damage the brain?
Evidence is presented, in this volume, for and against the thesis that single, self-limited seizures can damage the brain. Consideration must be given to the fact that there are many different types of seizures, which undoubtedly induce a variety of postictal consequences. Whether any of these consequences constitute brain damage depends upon the definition of damage, which could range from enduring functional changes of single neurons or circuits, to actual cell death. Although many seizure-induced mechanisms have been postulated, or even demonstrated, that can give rise to persistent neuronal disturbances, including neuronal death, they are only of clinical concern if they result in interictal neurological or cognitive dysfunction, developmental delay, or progressive epileptogenesis that makes seizures worse. Although animal studies indicate it is very likely that some seizures, under some circumstances, do, in fact, damage the brain in a clinically meaningful manner, the principal contribution of this volume is to identify areas of future basic and clinical research designed to identify those seizures which present a risk of causing enduring neuronal disruption, the circumstances under which these changes are likely to occur, their nature and effects on behavior, and, ultimately, rational approaches to prevention.
Engel
Jerome
J
Departments of Neurology and Neurobiology, Brain Research Institute, UCLA School of Medicine, 710 Westwood Plaza, Los Angeles, CA 90095-1769, USA. engel@ucla.edu
D000818:Animals; D001925:Brain Damage, Chronic / Q000209:etiology* / Q000473:pathology; D016923:Cell Death; D006801:Humans; D009474:Neurons / Q000473:pathology; D012640:Seizures / Q000150:complications / Q000473:pathology*