Download PDF
Indian Journal of Neurotrauma 2007; 04(01): 11-14
DOI: 10.1016/S0973-0508(07)80004-9
Review Article
Thieme Medical and Scientific Publishers Private Ltd.

The pathophysiology of post traumatic epilepsy

PK Sahoo
,
KI Mathai
,
GV Ramdas
,
MN Swamy
Subject Editor:
Further Information

Publication History

Publication Date:
05 April 2017 (online)

  PDF Download  Permissions and Reprints

Abstract

Posttraumatic epileptogenesis provides an opportunity for the clinician to study the phenomenon of seizurogenesis along with the process of apoptosis which is triggered by traumatic brain injury (TBI), there is a simultaneous effort at neuro regeneration, neo synaptogenesis and plasticity.

The seat of maximal neuronal changes after TBI is the hypothalamus. This loss of hilar cell inhibition of the hypothalamus on the CA3 region of the dentate gyrus results in mossy fibre sprouting and an attempt at neo synaptogenesis. While neo synaptogenesis is associated with long term potentiation (memory), it can also result in seizurogenesis. Pharmacologic inhibition of epileptogenesis remains in the realm of experimental therapeutics, but is likely to replace conventional antiepileptic drugs in the preventive management of post traumatic seizure disorder.

Keywords

traumatic brain injury - hypothalamic neo synaptogenesis
 

  • References

  • 1 Golorai G, Green wood AC, Feeney DM, Connor JA. Physiological and structural evidence for hippocampal involvement in persistent seizure susceptibility after traumatic brain injury. J Neurosci 21 2001; 8523-8537
    PubMedGoogle Scholar
  • 2 Mc Intosh TK, Sautman KE, Raghupathi R. Calcium and the pathogenesis of traumatic CNS injury, Cellular and molecular mechanisms. Neuroscientist 03 1997; 169-175
    CrossrefPubMedGoogle Scholar
  • 3 Dash PK, Mach SA, Moore AN. Enhanced neurogenesis in the rodent hippocampus following traumatic brain injury. J Neuro Res 63 2001; 313-319
    CrossrefPubMedGoogle Scholar
  • 4 Smith DH, Chen Xi, Pierce JE. et al Progressive atrophy & neuron death for one year following brain trauma in the rat. J Neurotrauma 14 1997; 715-727
    CrossrefPubMedGoogle Scholar
  • 5 Choi DW. Ionic dependence of glutamate neuro toxicity. J Neurosci 07 1987; 369-379
    PubMedGoogle Scholar
  • 6 Whalen MJ, Carlas TM, Kochanek PM. et al Soluble adhesion molecules, in CSF are increased in children with severe head injury. J Neurotrauma 15 1998; 777-787
    CrossrefPubMedGoogle Scholar
  • 7 Sharp FR, Lu A, Tang Y, Milhorn DE. Multiple molecular penumbras after cerebral ischemia. J Cereb Blood Flow Metab 20 2000; 1011-1032
    CrossrefPubMedGoogle Scholar
  • 8 Dhillon HS, Carman HM, Zhang D. Effect of severity of experimental brain injury on lactate & free fatly acid accumulation & Evans blue extravasations in the rat cortex & hippocampus. J Neurotrauma 16 1999; 455-469
    CrossrefPubMedGoogle Scholar
  • 9 Kontas Ha, George E. Brown memorial lecture. Oxygen radicals in cerebeal vascular injury. Circ Res 1985; 57-58
    PubMedGoogle Scholar
  • 10 Bramlett HM, Dietrich WD. Pathophysiology of cerebral ischemia and brain trauma similarities & differences. J Cereb Blood Flow Metab 24 2004; 133-150
    CrossrefPubMedGoogle Scholar
  • 11 Clark RSB, Chen M, Kochanek PM. et al Detection of single & double stranded DNA breaks after traumatic brain injury in rats: Comparison of in situ labeling techniques using DNA polymerase I, the klenow fragment of DNA polymerase I and terminal deoxy nucleo tidyl trans ferase. J Neurotrauma 08 2001; 675-689
    PubMedGoogle Scholar
  • 12 Wang KK. Calpain & Caspase: Can you tell the differences?. Trends Neuro Sci 23 2000; 20-26
    CrossrefPubMedGoogle Scholar
  • 13 Ver weif BH, Muizelaar JP, Vinas FC. et al Impaired cerebral mitochondrial function after traumatic brain injury in humans. J Neurosurg 93 2000; 815-820
    CrossrefPubMedGoogle Scholar
  • 14 Mayewc R, Ottman R, Tang M. et al Genetic susceptibility & head injury as risk factors for Alzheimer's disease among community dwelling elderly patients and their first degue relatives. Ann Neurology 33 1993; 494-501
    CrossrefPubMedGoogle Scholar
  • 15 Clark RS, Chen J, Watkins SC. et al Caspase mediated neuronal death after traumatic brain injury in rats. J Neurochem 74 2000; 740-753
    PubMedGoogle Scholar
  • 16 Whishaw IQ. Loss of innate cortical in gram for action patterns used in skilled reaching and the development of behavioral compensation following motor cortex lesions in the rat. Neuropharmacology 39 2000; 788-805
    CrossrefPubMedGoogle Scholar
  • 17 Jones TA. Multiple synapse formation in the motor cortex opposite unilateral sensory motor cortex lesions in adult rats. J Comp Neurol 414 1999; 57-66s
    CrossrefPubMedGoogle Scholar
  • 18 Hwang EJ, Reichardt LF. Neurotrophins: Roles in neuronal development and function. Ann Rev Neurosci 24 2001; 677-736
    CrossrefPubMedGoogle Scholar
  • 19 Mautes AE, Thome D, Stewdel WI. et al Changes in regional energy metabolism after closed head injury in the rat. J Mol Neurosci 16 2001; 33-39
    CrossrefPubMedGoogle Scholar
  • 20 Ahmed SM, Rzigalinski BA, Willoughby KA. et al Stretch induced injury alters mitochondrial membrane potential and cellular ATP in cultured astrocytes & neurons. J Neurochem 74 2000; 1951-1960
    CrossrefPubMedGoogle Scholar
  • 21 OAmbrosio R, Mares DO, Grady MS. et al Impaired K+ homeostasis and altered electro physiological properties of posttraumatic hippocampal glia. J Neurosci 14 1999; 8152-8162
    PubMedGoogle Scholar
  • 22 Choi DW. Glutamate neurotoxicity in cortical cell culture is Calcium dependent. Neurosci Let 58 1985; 293-297
    CrossrefPubMedGoogle Scholar
  • 23 Schwartzhain PA, Baraban SC, Hochman DW. Osmolarity, ionic flux and changes in brain excitability. Epilepsy Res 32 1998; 275-285
    CrossrefPubMedGoogle Scholar
  • 24 Rao VL, Dogan A, Bowen KK. et al Anti sense knockdown of glial glutamate transporter GLT -1, exacerbates hippocampal neuronal damage following traumatic brain injury in the rat brain. Eur J Neurosci 13 2001; 119-128
    PubMedGoogle Scholar
  • 25 Samuels CN, Kamlien E, Flink R. et al Decreased cortical levels of astrocytic glutamate transport protein in a sat model of post traumatic epilepsy. Neurosci Let 289 2000; 185-188
    CrossrefPubMedGoogle Scholar
  • 26 Dixon CE, Lyeth BG, Povlishoh JT. et al A fluid percussion model of experimental brain injury in the rat. J Neurosurg 67 1987; 110-119
    CrossrefPubMedGoogle Scholar
  • 27 Dudeh FE, Obenaus A, Schweitzes JS, Wuarin JP. Functional significance of hippocampal plasticity in epileptic brain: Electro physiologic changes of the dentate granule cells associated with mossy fibre sprouting. Hippocampus 04 1994; 259-265
    CrossrefPubMedGoogle Scholar
  • 28 Nirrinen J, Luhasuih K, Pitkanen A. Is mossy fibre sprouting present in rat experimental temporal lobe epilepsy?. Hippocampus 11 2001; 299-310
    CrossrefPubMedGoogle Scholar
  • 29 Adams B, Lee M, Fahnestoch M, Racine RJ. Long term potentiation trains induce mossy fibre sprouting. Brain Res 775 1997; 193-197
    CrossrefPubMedGoogle Scholar
  • 30 Temhin NR, Jarell AD, Andereson GD. Anti epileptogenic agents: How close are we?. Drugs 61 2001; 1045-1055
    CrossrefPubMedGoogle Scholar
  • 31 Lowenstein DH, Thomas MJ, Smith DH, McIntosh TK. Selective vulnerability of dentate hilar neurons following traumatic brain injury: A potential link between head trauma and disorders of the hippocampus. J Neurosci 12 1992; 4841-4853
    PubMedGoogle Scholar
  • 32 Santha Kumar V, Ratzliff AD, Jeng J. et al Long term hyper excitability in the hippocampus after experimental head trauma. Ann Neurol 50 2001; 708-717
    CrossrefPubMedGoogle Scholar
  • 33 Graber KD, Prince DA. Tetradorin prevents posttraumatic epileptogenesis in rats. Ann Neurol 49 1999; 234-242
    PubMedGoogle Scholar
  • 34 Nortge J, Menon DK. Traumatic brain injury: Physiology, mechanisms and out come. Curr Opin Neurol 17 2004; 711-718
    CrossrefPubMedGoogle Scholar
  • 35 Hillered L, Vesha PM, Hovda DA. Translational neuro chemical research in acute human brain injury: The current status and potential future for cerebral micro dialysis. J Neurotrauma 22 2005; 3-41
    CrossrefPubMedGoogle Scholar
  • 36 Gennarelli TA, Thibault LE, Graham DI. Diffuse axonal injury: An important form of traumatic brain injury. Neuroscientist 04 1998; 202-215
    CrossrefPubMedGoogle Scholar
  • 37 Levy R, Mattsan R, Meldrum B. editors. Antiepileptic drugs. 4th. ed. 1995. Raven Publishers; New York: