Clinical presentations of post ischemic and post traumatic brain injury scars associated seizures.

Abstract

Objectives: Deep scarring inside the temporal lobe of the brain commonly causes focal seizures and structural epilepsy. Temporal herniation/protrusion including encephaloceles deduced by head and skull injury causes refractory epilepsy. In addition to debilitating seizures, epilepsy can cause cognitive and emotional problems with reduced quality of life.

Methods: The major aim is to prevent the disorder in the first place: identify, detect, and reverse the processes responsible for its onset, and monitor and treat its progression.

Results: Epilepsy often occurs following a latent period of months to years (epileptogenesis) because of brain insults, such as head trauma, stroke, or status epilepticus. Although this latent period clearly represents a therapeutic window, we are not able to stratify patients at risk for long-term epilepsy, which is prerequisite for preventative clinical trials. Moreover, because of the length of the latent period, an early biomarker for treatment response would be of high value. Finally, mechanistic biomarkers of epileptogenesis may provide more profound insight into the process of disease development.

Discussion: This review discussed the pathophysiology associated with glial cells in scar epileptogenesis, neurological manifestations, clinical interventions, and current diagnostic and therapeutic approaches.