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癫痫发作活动与脑损伤之间的因果关系。

Causal correlation between seizure activity and brain damage.

作者信息

Librizzi Laura, Verde Diogo Vila, de Curtis Marco

机构信息

Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.

出版信息

Neurol Sci. 2025 May 22. doi: 10.1007/s10072-025-08209-4.

Abstract

INTRODUCTION

The correlation between seizure activity and brain damage represents one of the critical issue in epilepsy. In spite of the extensive literature on the topic, very few studies addressed the causal relation between brain tissue worsening and seizure recurrence. We specifically address this issue in the present manuscript. We define potential scenarios and review evidence of causality between seizures recurrence and brain injury in focal structural epilepsies, such as temporal lobe epilepsy and focal cortical dysplasia and extend the analysis to the pathophysiology of the aging brain.

RESULTS

Experimental findings based on temporal lobe epilepsy models suggest that only conditions characterized by convulsive status epilepticus can induce secondary epileptogenesis that add injury to the brain tissue. When addressing late-onset epilepsies in elderly, it is still not clear whether seizures exacerbate the progression of the underlying pathological brain condition.

CONCLUSION

At the light of these results, we cannot conclude that seizures as such are responsible for a direct alteration of the brain tissue, whereas experimental evidence suggests that severe convulsive seizures may worsen an ongoing pathological process.

摘要

引言

癫痫发作活动与脑损伤之间的关联是癫痫领域的关键问题之一。尽管关于该主题的文献众多,但很少有研究探讨脑组织恶化与癫痫复发之间的因果关系。我们在本手稿中专门探讨了这个问题。我们定义了潜在的情况,并回顾了局灶性结构性癫痫(如颞叶癫痫和局灶性皮质发育异常)中癫痫复发与脑损伤之间因果关系的证据,并将分析扩展到衰老大脑的病理生理学。

结果

基于颞叶癫痫模型的实验结果表明,只有以惊厥性癫痫持续状态为特征的情况才能诱发继发性癫痫发生,从而加重脑组织损伤。在研究老年人迟发性癫痫时,癫痫发作是否会加剧潜在的病理性脑部疾病的进展仍不清楚。

结论

鉴于这些结果,我们不能得出癫痫发作本身会直接改变脑组织的结论,而实验证据表明严重的惊厥性发作可能会使正在进行的病理过程恶化。

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