title: A role for inflammation in status epilepticus is revealed by a review of current therapeutic approaches.
abstract: A significant number of patients with epilepsy fail to respond to currently available antiepileptic drugs. This suggests a need for alternative approaches to reduce the occurrence of seizures in these patients. Recent data have shown that in addition to well-known neuronal mechanism, seizures may be a consequence of misguided inflammatory response and blood-brain barrier disruption. Both peripheral and brain proinflammatory events have been demonstrated to govern the onset of status epilepticus. Evidence deriving from the experimental and clinical realms supports the notion that a role for proinflammatory and cerebrovascular events in seizure disorders is broader than previously suspected. As a result, methods to pharmacologically reduce blood-brain barrier permeability and reduce inflammation have emerged as means to reduce seizure burden. For instance, corticosteroids have been shown to be beneficial and the same agents may be able to further reduce seizure burden in conjunction with currently prescribed antiepileptic drugs.
authors.affiliation: Departments of Neurological Surgery, Cellular and Molecular Medicine, Cleveland Clinic Foundation, 9500 Euclid Ave., Cleveland, OH 44195, U.S.A. janigrd@ccf.org
authors.forename: Damir
authors.initials: D
authors.lastname: Janigro
authors.forename: Philip H
authors.initials: PH
authors.lastname: Iffland
authors.forename: Nicola
authors.initials: N
authors.lastname: Marchi
authors.forename: Tiziana
authors.initials: T
authors.lastname: Granata
mesh_terms: D000818:Animals; D000927:Anticonvulsants / Q000627:therapeutic use*; D001812:Blood-Brain Barrier / Q000503:physiopathology; D006801:Humans; D007249:Inflammation / Q000188:drug therapy; D013226:Status Epilepticus / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D000927:Anticonvulsants
keywords: Antiepileptic drugs; Blood-brain barrier; Glucocorticosteroids; Seizures