Brain inflammation in epilepsy: experimental and clinical evidence

Epilepsia. 2005 Nov;46(11):1724-43. doi: 10.1111/j.1528-1167.2005.00298.x.

Abstract

Inflammatory reactions occur in the brain in various CNS diseases, including autoimmune, neurodegenerative, and epileptic disorders. Proinflammatory and antiinflammatory cytokines and related molecules have been described in CNS and plasma, in experimental models of seizures and in clinical cases of epilepsy. Inflammation involves both the innate and the adaptive immune systems and shares molecules and pathways also activated by systemic infection. Experimental studies in rodents show that inflammatory reactions in the brain can enhance neuronal excitability, impair cell survival, and increase the permeability of the blood-brain barrier to blood-borne molecules and cells. Moreover, some antiinflammatory treatments reduce seizures in experimental models and, in some instances, in clinical cases of epilepsy. However, inflammatory reactions in brain also can be beneficial, depending on the tissue microenvironment, the inflammatory mediators produced in injured tissue, the functional status of the target cells, and the length of time the tissue is exposed to inflammation. We provide an overview of the current knowledge in this field and attempt to bridge experimental and clinical evidence to discuss critically the possibility that inflammation may be a common factor contributing, or predisposing, to the occurrence of seizures and cell death, in various forms of epilepsy of different etiologies. The elucidation of this aspect may open new perspectives for the pharmacologic treatment of seizures.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Anti-Inflammatory Agents / pharmacology
  • Anti-Inflammatory Agents / therapeutic use
  • Anticonvulsants / pharmacology
  • Anticonvulsants / therapeutic use
  • Autoimmune Diseases of the Nervous System / immunology
  • Autoimmune Diseases of the Nervous System / physiopathology
  • Blood-Brain Barrier / immunology
  • Blood-Brain Barrier / physiopathology
  • Capillary Permeability / immunology
  • Cell Death / immunology
  • Cell Survival / immunology
  • Cell Survival / physiology
  • Disease Models, Animal
  • Encephalitis / immunology*
  • Encephalitis / physiopathology*
  • Endothelial Cells / immunology
  • Endothelial Cells / physiology
  • Epilepsy / immunology*
  • Epilepsy / physiopathology*
  • Humans
  • Inflammation Mediators / immunology
  • Inflammation Mediators / physiology
  • Nerve Degeneration / immunology
  • Nerve Degeneration / physiopathology
  • Seizures / immunology
  • Seizures / physiopathology

Substances

  • Anti-Inflammatory Agents
  • Anticonvulsants
  • Inflammation Mediators