N-3 fatty acids (eicosapentanoic and docosahexanoic acids) in epilepsy and for the prevention of sudden unexpected death in epilepsy

Abstract

As described in this journal, Bromfield et al. and Yuen et al. tested the hypothesis that n-3 fatty acids may reduce seizures [ 1 Bromfield E. Dworetzsky B. Huwitz S. et al. A randomized trial of polyunsaturated fatty acids for refractory epilepsy. Epilepsy Behav. 2008; 12: 187-190 Abstract Full Text Full Text PDF PubMed Scopus (83) Google Scholar , 2 Yuen A.W. Sander J.W. Fluegel D. et al. Omega-3 fatty acid supplementation in patients with chronic epilepsy: a randomized trial. Epilepsy Behav. 2005; 7: 253-258 Abstract Full Text Full Text PDF PubMed Scopus (140) Google Scholar ]. This is important work, founded in sound science. It is known that eicosapentanoic acid reduces the frequency of hippocampal pyramidal neuron firing rates [ [3] Xiao Y. Li X. Polyunsaturated fatty acids modify mouse hippocampal neuronal excitability during excitotoxic or convulsant stimulation. Brain Res. 1999; 846: 112-121 Crossref PubMed Scopus (114) Google Scholar ]. Furthermore, n-3 fatty acids reduce the number and increase the latency of pentylenetetrazole- and FeCl3-induced seizures, reduce seizure severity in rodents, and improve cognitive recovery after acute seizures [ 4 Yehuda S. Carasso R. Mostofsky D. Essential fatty acid preparation (SR-3) raises the seizure threshold in rats. Eur J Pharmacol. 1994; 254: 193-198 Crossref PubMed Scopus (121) Google Scholar , 5 Voskuyl R. Vregdenhil M. Kang J. et al. Anticonvulsant effect of polyunsaturated fatty acids in rats, using the cortical stimulation model. Eur J Pharmacol. 1998; 341: 145-152 Crossref PubMed Scopus (121) Google Scholar , 6 Rabinovitz S. Mostofsky D. Yehuda S. Anticonvulsant efficiency, behavioral performance, and cortisol levels: a comparison of carbamazepine (CBZ) and a fatty acid compound (SR-3). Psychoneuroendocrinology. 2004; 29: 113-124 Abstract Full Text Full Text PDF PubMed Scopus (39) Google Scholar ]. Moreover, in an important discovery recently reported in this journal, Ferrari et al. found that n-3 fatty acids prevent or reduce hippocampal neuronal injury after status epilepticus [ [7] Ferrari D. Cysneiros R.M. Scorza C. et al. Neuroprotective activity of omega-3 fatty acids against epilepsy-induced hippocampal damage: quantification with immunohistochemical for calcium-binding proteins. Epilepsy Behav. 2008; 13: 36-42 Abstract Full Text Full Text PDF PubMed Scopus (56) Google Scholar ].