Developmental Epilepsy: From Clinical Medicine to Neurobiological Mechanisms (PDF)
The book is introduced by a chapter on brain development to provide a background for understanding when and how seizures and epilepsy can emerge. Recent clinical research indicates strong relationship between childhood epilepsy and developmental cognitive impairment. This connection can be studied in experimental animals and can uncover developmental mechanisms common to both conditions. Targeting those mechanisms might reveal disease-modifying treatments. Febrile seizures are very common in the pediatric population and their impact on further epilepsy development is explored. The link between immunity, inflammation and epileptogenesis in the developing brain is explored. Many developmental epilepsies arise from brain malformations or neuronal migration deficits; some juvenile epilepsies have a clear genetic basis while the etiology of others is less certain. Recently, the involvement of the mTOR pathway in certain childhood epilepsy syndromes was recognized, prompting the repurposing of drugs used in cancer treatment for therapy of these specific epilepsy syndromes. Steroid hormones have significant hormonal effects on neurotransmitter receptors and function, and therefore have an impact on childhood epilepsy; sex steroids may have long term organizational effects on brain structure and epilepsy development. Stress, even early in development, may affect the developing brain and lead to behavioral changes as well as increased susceptibility to seizures.