Ailion Alyssa, Helmstaedter Christoph, Vezzani Annamaria, Koepp Matthias J
Departments of Psychiatry and Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Department of Epileptology - Clinical Neuropsychology, University Hospital Bonn, Bonn, Germany.
Epilepsia Open. 2025 Aug;10(4):987-998. doi: 10.1002/epi4.70088. Epub 2025 Jun 30.
The persistence of common, heritable conditions, like epilepsy, that are associated with reduced reproductive fitness is an evolutionary paradox. Endogenous analgesic, anti-depressant, and inflammatory mechanisms able to repair compromised functions can offer advantages in unexpected crises. Here, we challenge current thinking about the detrimental effects of seizures and epilepsy and suggest that (1) seizure-driven neuroplasticity might provide a protective mechanism, (2) seizure-induced neurotransmitter release not only helps to stop seizures but also increases resilience to pain, and (3) innate immune mechanisms triggered by recurrent seizures might neutralize novel viruses, like SARS-CoV-2, more rapidly, and so provided protection during the recent pandemic. PLAIN LANGUAGE SUMMARY: We explore the idea that epilepsy may activate the brain's natural repair systems, despite its risks. These include brain processes that help people recover from injury, infections, and reduce pain. Understanding these less frequently discussed aspects of seizures may help researchers develop novel questions and improve treatment.
像癫痫这种常见的、具有遗传性且与生殖适应性降低相关的病症持续存在，是一个进化悖论。能够修复受损功能的内源性镇痛、抗抑郁和炎症机制，在意外危机中可能具有优势。在此，我们对当前关于癫痫发作和癫痫有害影响的观点提出质疑，并认为：（1）癫痫发作驱动的神经可塑性可能提供一种保护机制；（2）癫痫发作诱导的神经递质释放不仅有助于终止癫痫发作，还能增强对疼痛的耐受性；（3）反复癫痫发作触发的先天免疫机制可能更迅速地中和新型病毒，如SARS-CoV-2，从而在近期的大流行期间提供保护。通俗易懂的总结：我们探讨了这样一种观点，即癫痫尽管存在风险，但可能会激活大脑的自然修复系统。这些系统包括帮助人们从损伤、感染中恢复并减轻疼痛的大脑过程。了解癫痫发作这些较少被讨论的方面，可能有助于研究人员提出新问题并改进治疗方法。
