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Cardiovascular Psychiatry and Neurology
Volume 2011 (2011), Article ID 482415, 9 pages
http://dx.doi.org/10.1155/2011/482415
Review Article

The Etiological Role of Blood-Brain Barrier Dysfunction in Seizure Disorders

1Department of Molecular Medicine, Cleveland Clinic Foundation, NB-20 LRI 9500 Euclid Avenue, Cleveland, OH 44195, USA
2Department of Cell Biology, Cleveland Clinic Foundation, NB-20 LRI 9500 Euclid Avenue, Cleveland, OH 44195, USA
3Epilepsy Center, Cleveland Clinic Foundation, NB-20 LRI 9500 Euclid Avenue, Cleveland, OH 44195, USA
4Division of Child Neurology, Carlo Besta Neurological Institute, 20133 Milan, Italy
5Cerebrovascular Center, Cleveland Clinic Foundation, NB-20 LRI 9500 Euclid Avenue, Cleveland, OH 44195, USA

Received 10 November 2010; Accepted 28 January 2011

Academic Editor: Alon Friedman

Copyright © 2011 Nicola Marchi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A wind of change characterizes epilepsy research efforts. The traditional approach, based on a neurocentric view of seizure generation, promoted understanding of the neuronal mechanisms of seizures; this resulted in the development of potent anti-epileptic drugs (AEDs). The fact that a significant number of individuals with epilepsy still fail to respond to available AEDs restates the need for an alternative approach. Blood-brain barrier (BBB) dysfunction is an important etiological player in seizure disorders, and combination therapies utilizing an AED in conjunction with a “cerebrovascular” drug could be used to control seizures more effectively than AED therapy alone. The fact that the BBB plays an etiologic role in other neurological diseases will be discussed in the context of a more “holistic” approach to the patient with epilepsy, where comorbidity variables are also encompassed by drug therapy.