Table of Contents
Cardiovascular Psychiatry and Neurology
Volume 2011, Article ID 130406, 7 pages
http://dx.doi.org/10.1155/2011/130406
Hypothesis

Occult Cerebrovascular Disease and Late-Onset Epilepsy: Could Loss of Neurovascular Unit Integrity Be a Viable Model?

1Department of Acute Medicine, Western General Hospital, Edinburgh EH4 2XU, UK
2Faculty of Life Sciences, University of Manchester, AV Hill Building, Oxford Road, Manchester M13 9PT, UK
3School of Cancer and Imaging Sciences, University of Manchester, Stopford Building, Oxford Road, Manchester M13 9PT, UK
4Department of Neurology, Royal Preston Hospital, Fulwood, Preston PR2 9HT, UK

Received 27 August 2010; Revised 13 December 2010; Accepted 30 December 2010

Academic Editor: Alon Friedman

Copyright © 2011 Lorna M. Gibson 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

Late-onset epilepsy (LOE) first occurs after 60 years of age and may be due to occult cerebrovascular disease (CVD) which confers an increased risk of stroke. However, patients with late-onset epilepsy are not currently consistently investigated or treated for cerebrovascular risk factors. We discuss how abnormalities of neurovascular unit function, namely, changes in regional cerebral blood flow and blood brain barrier disruption, may be caused by occult cerebrovascular disease but present clinically as late-onset epilepsy. We describe novel magnetic resonance imaging methods to detect abnormal neurovascular unit function in subjects with LOE and controls. We hypothesise that occult CVD may cause LOE as a result of neurovascular unit dysfunction.