Holmes G L, Ben-Ari Y
Department of Neurology, Harvard Medical School, Center for Research in Pediatric Epilepsy, Children's Hospital, Boston, Massachusetts 02115, USA.
Pediatr Res. 2001 Mar;49(3):320-5. doi: 10.1203/00006450-200103000-00004.
Epilepsy is a disorder in which the balance between cerebral excitability and inhibition is tipped toward uncontrolled excitability. There is now clear evidence that there are distinct differences between the immature and mature brain in the pathophysiology and consequences of seizures. Both the enhanced excitability of the immature brain compared with the mature brain and the unique pathologic consequences of seizures are related to the sequential development and expression of essential signaling pathways. Although the immature brain is less vulnerable than the mature brain to seizure-induced cell death, seizures in the developing brain can result in irreversible alterations in neuronal connectivity. Developing novel strategies to treat and avert the consequences of seizures in children will require further understanding of the unique mechanisms of seizure initiation and propagation in the immature brain.
癫痫是一种大脑兴奋性与抑制性之间的平衡向不受控制的兴奋性倾斜的疾病。现在有明确证据表明，在癫痫发作的病理生理学和后果方面，未成熟大脑和成熟大脑存在明显差异。与成熟大脑相比，未成熟大脑兴奋性增强以及癫痫发作独特的病理后果均与关键信号通路的顺序发育和表达有关。虽然未成熟大脑比成熟大脑对癫痫发作诱导的细胞死亡更不易受影响，但发育中大脑的癫痫发作可导致神经元连接发生不可逆改变。制定治疗和避免儿童癫痫发作后果的新策略需要进一步了解未成熟大脑中癫痫发作起始和传播的独特机制。
