Before Epilepsy Unfolds: Opening up the potassium door in neonatal seizures

There is increasing interest in understanding how epilepsy initiates and how to thwart the establishment of the disease. Many questions remain open as to what targets may the best for preventing epilepsy and whether any common triggering pathway exists to treat this complex malady. In 'Bedside to Bench', Rod C. Scott and Gregory Holmes discuss alternative therapies to treat neonatal seizures to prevent chronic cognitive impairment and brain developmental problems, which can lead to epilepsy later in life. Increasing inhibitory signals in the developing brain may be useful in dampening brain hyperexcitability—and enhanced susceptibility for seizures—and blocking epilepsy development in children. In 'Bench to Bedside', Annamaria Vezzani argues how the mTOR pathway may be a potential target for blocking epileptogenesis. The role of mTOR in seizures in early life and progression of established disease raises the possibility that mTOR could be a common mediator involved in epilepsy at different stages of disease initiation and progression. Given the lack of current antiepileptic drugs to prevent seizures in children and to block epileptogenesis, developing new disease-modifying therapies remains a priority.

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Figure 1: Receptor and channel development in the newborn rat.

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Correspondence to Gregory L Holmes.

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Declaration: G.H. has previously served on the scientific advisory board of GlaxoSmithKline.

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Scott, R., Holmes, G. Before Epilepsy Unfolds: Opening up the potassium door in neonatal seizures. Nat Med 18, 1624–1625 (2012). https://doi.org/10.1038/nm.2987

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