Epilepsy accounts for 0.5% of the global burden of disease, and primary prevention of epilepsy represents one of the three 2007 NINDS Epilepsy Research Benchmarks. In the past decade, efforts to understand and intervene in the process of epileptogenesis have yielded fruitful preventative strategies in animal models. This article reviews the current understanding of epileptogenesis, introduces the concept of a "critical period" for epileptogenesis, and examines strategies for epilepsy prevention in animal models of both acquired and genetic epilepsies. We discuss specific animal models, which may yield important insights into epilepsy prevention including kindling, poststatus epilepticus, prolonged febrile seizures, traumatic brain injury, hypoxia, the tuberous sclerosis mouse model, and the WAG/Rij rat model of primary generalized epilepsy. Hopefully, further investigation of antiepileptogenesis in animal models will soon enable human therapeutic trials to be initiated, leading to long-term epilepsy prevention and improved patient quality of life. Keywords epileptogenesis; prevention; activity dependent; animal models; acquired epilepsy; idiopathic generalized epilepsy Epilepsy is a disorder characterized by chronically recurring seizures without clear precipitants. The age-adjusted prevalence of epilepsy is in the range of 4 to 10 per 1000 people in most locations (Sander 2003; Forsgren and others 2005). The burden associated with epilepsy is great, both for the individual with epilepsy and for society at large. Epilepsy can negatively impact cognitive function, is a source of social stigma and legal marginalization, causes increased mortality, economically contributes 0.5% of the global burden of disease, and is associated with an increased risk of psychiatric disorder (de Boer and others 2008). As such, epilepsy prevention is one of the three 2007 NINDS Epilepsy Research Benchmarks (Kelley and others 2009).Work on epilepsy prevention can for the most part be parsed into prevention of epilepsy after a known inciting event (acquired epilepsy), and prevention of epilepsy in genetic © The Author(s) 2010Corresponding Author: Hal Blumenfeld, Yale University School of Medicine, Departments of Neurology, Neurobiology, and Neurosurgery, 333 Cedar Street, New Haven, CT 06520-8018, hal.blumenfeld@yale.edu.
Declaration of Conflicting InterestsThe authors declared no potential conflicts of interests with respect to the authorship and/or publication of this article.
NIH Public Access
Author ManuscriptNeuroscientist. Author manuscript; available in PMC 2010 July 28.
NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript models where the time of epilepsy development is well characterized and may be dependent on a transient developmental milieu. Both of these approaches rest upon identification of epileptogenesis, understanding of the und erlying mechanisms of epilepsy development, and intervention targeted to these mechanisms in an appropriate time period. While prevention of epilepsy in human su...