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Review
. 2019 Mar:123:20-26.
doi: 10.1016/j.nbd.2018.06.022. Epub 2018 Jul 18.

Breakdown of blood brain barrier as a mechanism of post-traumatic epilepsy

Aaron Dadas  1 , Damir Janigro  2
Affiliations
Review

Breakdown of blood brain barrier as a mechanism of post-traumatic epilepsy

Aaron Dadas et al. Neurobiol Dis. 2019 Mar.

Abstract

Traumatic brain injury (TBI) accounts for approximately 16% of acute symptomatic seizures which usually occur in the first week after trauma. Children are at higher risk for post-traumatic seizures than adults. Post-traumatic seizures are a risk factor for delayed development of epilepsy. Delayed, chronic post-traumatic epilepsy is preceded by a silent period during which therapeutic interventions may arrest, revert or prevent epileptogenesis. A number of recent review articles summarize the most important features of post-traumatic seizures and epilepsy; this review will instead focus on the link between cerebrovascular permeability, epileptogenesis and ictal events after TBI. The possibility of acting on the blood-brain barrier (BBB) and the neurovascular unit to prevent, disrupt or treat post-traumatic epilepsy is also discussed. Finally, we describe the latest quest for biomarkers of epileptogenesis which may allow for a more targeted intervention.

Keywords: Anti-epileptic drugs; Blood-brain barrier; Fluid biomarkers; Peripheral markers; Post-traumatic epilepsy; Traumatic brain injury.

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Figures

Fig. 1.
Fig. 1.
The complex reality of post-traumatic sequelae confound the predictive properties of biomarkers. See text for details.
Fig. 2.
Fig. 2.
Mechanisms of biomarker extravasation in blood after TBI. See text.
See this image and copyright information in PMC

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