An Update on Post-Traumatic Epilepsy

Abstract

Purpose of ReviewOur aim was to revisit important defining terms and concepts regarding post-traumatic epilepsy that reflect a modern view of the condition, as well as update the reader on the current understanding of the pathophysiological mechanisms behind post-traumatic epileptogenesis and how this frames future work on identifying reliable electroencephalographic, serum, and CSF biomarkers to better study and develop treatments for preventing and modifying post-traumatic epilepsy.Recent FindingsThe epileptogenic process involves a complex interplay of blood-brain barrier disruption, neuroinflammation, loss of inhibitory neural circuitry and unregulated neuronal plasticity. Potential biomarkers include epileptiform abnormalities and electrographic seizures on EEG, IL-1β, and downregulation of BDNF. Targets of interest for suppressing epileptogenesis include ceftriaxone, retigabine, and TrkB receptor agonists.SummaryMeaningful research on post-traumatic seizures and PTE relies on an accurate understanding of the condition via updated terminology. As the complex interplay of multiple inflammatory cascades involved in secondary brain injury has become clearer, new options for monitoring the epileptogenic process have emerged, along with potential targets for intervention.