title: [Neuronal communication and synaptic metabolism in childhood epilepsy].
abstract: BACKGROUND
  Basic neuroscience and neurometabolism are providing a rapidly increasing amount of knowledge on paediatric epilepsy and, more specifically, on the mechanisms involved in synaptic communication. There is, however, a mismatch between these advances and a vision that integrates them in a global way, in clinical and therapeutic practice.
  
  
  OBJECTIVE
  To offer an integrative view of the different molecular and metabolic mechanisms that are known and postulated in paediatric epilepsy, and to suggest concepts such as 'synaptic metabolism' and 'synaptic phenotypes' as useful tools for developing this approach.
  
  
  METHODS
  We also review the most notable studies that attempt to explain the essential characteristics of synaptic communication in the developing brain by means of different molecules, essentially synaptic proteins, ion channels (chlorine, sodium and potassium co-transporters), and pre- and post-synaptic compartmentalisation, as well as the main players in metabolism (neurotransmitters, energy metabolism, growth factors and lipids). This combination of biological mechanisms has led to examples of 'synaptic phenotypes' being suggested in two specific cases of genetic (SCN1A) and metabolic epilepsy (epilepsy with response to pyridoxine).
  
  
  CONCLUSIONS
  A holistic perspective, which takes into account the diversity of elements that are related and which take place at certain times in neurodevelopment, can help to define phenotypes, channels for synaptic metabolism and brain connectivity, which facilitate not only the understanding of the pathophysiology, but also new therapeutic approaches in paediatric epilepsy.
authors.affiliation: Hospital Sant Joan de Deu, Esplugues de Llobregat, Espana.
authors.forename: Àngels
authors.initials: À
authors.lastname: García-Cazorla
authors.forename: Elisenda
authors.initials: E
authors.lastname: Cortès-Saladelafont
authors.forename: Sofia
authors.initials: S
authors.lastname: Duarte
mesh_terms: D002648:Child; D004734:Energy Metabolism; D004827:Epilepsy / Q000378:metabolism* / Q000503:physiopathology*; D006801:Humans; D050356:Lipid Metabolism; D009415:Nerve Net / Q000503:physiopathology*; D018377:Neurotransmitter Agents / Q000502:physiology; D013569:Synapses / Q000378:metabolism*
chemical_list: D018377:Neurotransmitter Agents