[Pathophysiology of epilepsies: recent progresses].
Epilepsy is often due to an initial aggression (brain trauma etc.). Decades can pass before the appearance of spontaneous recurrent seizures. It is therefore important to understand the mechanisms responsible for the construction of an epileptic brain. Understanding these mechanisms would open the way to preventive treatments.The probability of appearance of epilepsy after an initial insult is rather low. A preventive treatment can only be applied if predictive markers exist. The occurrence of interictal spikes and the presence of cognitive deficits could constitute early markers of epileptogenesis (the process leading to epilepsy). Epileptogenesis can be studied in animal models of epilepsy. In these models, the opening of the brain blood barrier, the neuro-inflammatory response, and the activation of some genes play a pivotal role in epileptogenesis. Therapeutical interventions targeting these candidates have beneficial effects, delaying epileptogenesis, but not preventing them. Future research directions for the early treatment of at-risk patients will be discussed.
Inserm U 751, 13385 Marseille cedex 05, France. christophe.bernard@univmed.fr
Christophe
C
Bernard
D000818:Animals; D000927:Anticonvulsants / Q000627:therapeutic use; D001812:Blood-Brain Barrier / Q000187:drug effects / Q000502:physiology; D001921:Brain / Q000187:drug effects / Q000503:physiopathology*; D020747:Calcium Channels, T-Type / Q000235:genetics; D004195:Disease Models, Animal; D042241:Early Diagnosis; D004569:Electroencephalography; D042783:Endothelial Cells / Q000187:drug effects / Q000276:immunology; D004827:Epilepsy / Q000188:drug therapy / Q000209:etiology / Q000235:genetics / Q000503:physiopathology*; D005071:Evoked Potentials / Q000187:drug effects / Q000502:physiology; D015870:Gene Expression / Q000187:drug effects / Q000235:genetics; D024243:HMGB1 Protein / Q000235:genetics; D006801:Humans; D007249:Inflammation / Q000235:genetics / Q000503:physiopathology; D007962:Leukocytes / Q000187:drug effects / Q000276:immunology; D009474:Neurons / Q000187:drug effects / Q000502:physiology; D012097:Repressor Proteins / Q000235:genetics; D012307:Risk Factors; D012815:Signal Processing, Computer-Assisted; D051197:Toll-Like Receptor 4 / Q000235:genetics; D000099229:RE1-Silencing Transcription Factor
D000927:Anticonvulsants; D020747:Calcium Channels, T-Type; D024243:HMGB1 Protein; D012097:Repressor Proteins; D051197:Toll-Like Receptor 4; D000099229:RE1-Silencing Transcription Factor; C479952:CACNA1H protein, human; C495345:TLR4 protein, human