Brain pathology in focal status epilepticus: evidence from experimental models. (December 2021)

• Record Type: Journal Article
• Authors: de Curtis, Marco; Rossetti, Andrea O.; Verde, Diogo Vila; van Vliet, Erwin A.; Ekdahl, Christine T.
• Is Part Of: Neuroscience and biobehavioral reviews. Volume 131(2021)
• Page Start: 834
• Page End: 846
• Publication Date: 2021-12
• Subjects: BBB Blood-brain barrier -- FncSE focal non-convulsive status epilepticus -- FbcSE focal onset evolving into bilateral convulsive status epilepticus -- FSE focal status epilepticus -- KA kainic acid -- ncSE non-convulsive status epilepticus -- PILO pilocarpine -- SRS spontaneous recurrent seizures -- SE status epilepticus -- SUDEP sudden unexpected death in epilepsy -- TLE temporal lobe epilepsy; Epilepsy -- Status epilepticus -- Animal models -- Brain damage -- Gliosis; Psychophysiology -- Periodicals; Human behavior -- Periodicals; Animal behavior -- Periodicals; Neurology -- Periodicals; Behavior -- Periodicals; Ethology -- Periodicals; Neurology -- Periodicals; Psychophysiologie -- Périodiques; Comportement humain -- Périodiques; Animaux -- Mœurs et comportement -- Périodiques; Neurologie -- Périodiques; Animal behavior; Human behavior; Neurology; Psychophysiology; Periodicals; Electronic journals; 573.8
• DOI: 10.1016/j.neubiorev.2021.09.011
• Languages: English
• ISSNs: 0149-7634

Abstract

Highlights: The correlation between focal status epilepticus and brain damage is a clinically relevant issue recently revitalized by the new SE classification by the International League Against Epilepsy (Epilepsia 2015; DOI: 10.1111/epi.13121). The large literature developed since the early' 80 on animal models of focal SE is reviewed in the light of the concepts expressed in ILAE SE classification. The review of the literature demonstrates that non convulsive focal status epilepticus worsens the brain damage at the site of action of the epileptogenic agent. Brain alterations are not commonly observed beyond the region of primary epileptogenic insult. Abstract: Status Epilepticus (SE) is often a neurological emergency characterized by abnormally sustained, longer than habitual seizures. The new ILAE classification reports that SE "… can have long-term consequences including neuronal death, neuronal injury…depending on the type and duration of seizures ". While it is accepted that generalized convulsive SE exerts detrimental effects on the brain, it is not clear if other forms of SE, such as focal non-convulsive SE, leads to brain pathology and contributes to long-term deficits in patients. With the available clinical and experimental data, it is hard to discriminate the specific action of the underlying SE etiologies from that exerted by epileptiform activity. This information is highly relevant in the clinic for better treatment stratification, which may include both medical and surgical intervention for seizure control. Here we review experimental studies of focal SE, with an emphasis on focal non-convulsive SE. We present a repertoire of brain pathologies observed in the most commonly used animal models and attempt to establish a link between experimental findings and human condition(s). The extensive literature on focal SE animal models suggest that the current approaches have significant limitations in terms of translatability of the findings to the clinic. We highlight the need for a more stringent description of SE features and brain pathology in experimental studies in animal models, to improve the accuracy in predicting clinical translation.