Summary:Coupling between local cerebral blood flow and local cerebral metabolic rate for glucose is involved in the pathogenesis of epilepsy-related neuronal damage in the adult brain; however, its role in the immature brain is unknown. Lithium-pilocarpine-induced status epilepticus is associated with extended damage in adult rats, mostly in the forebrain limbic areas and thalamus, whereas damage was moderate in 21-day-old rats (P21) or absent in P10 rats. The quantitative autoradiographic [14 C]iodoantipyrine technique was applied to measure the consequences of lithium-pilocarpine status epilepticus on local cerebral blood flow. In adult and P21 rats, local cerebral blood flow rates increased by 50% to 400%; the highest increases were recorded in regions showing damage in adults. At P10, local cerebral blood flow rates decreased by 40% to 60% in most areas, except in some forebrain regions showing no change during status epilepticus. In areas injured when status epilepticus was induced in adults, a strong hypermetabolism (Fernandes et al., 1999) not matched by comparable local cerebral blood flow increases was present in rats of all ages, whereas in damage-resistant areas, local cerebral metabolic rate for glucose and local cerebral blood flow remained coupled in the three age groups. Thus, the level of coupling between blood flow supply and metabolism is not involved in seizure-related brain damage in the developing brain, which appears to be resistant to the consequences of such a mismatch. Key Words: Cerebral blood flow-Coupling between flow and metabolism-Seizures-Lithium-pilocarpine-Postnatal development-Neuronal damage.Changes in cerebral blood flow and metabolism in epilepsy have been of interest because of their involvement in the pathogenesis of neurologic damage. Indeed, during severe and prolonged seizures or status epilepticus (SE), large and sustained metabolic increases were recorded that are correlated with neuronal damage in various experimental models of severe seizures or SE (Meldrum, 1983;Ingvar, 1986;Handforth and Treiman, 1995). Nevander et al. (1985) showed that in vulnerable areas, after an initial marked metabolic increase, local cerebral metabolic rates for glucose (LCMR glc 's) return to normal levels and eventually decrease below the level recorded in the control situation as seizures continue; these low levels of LCMR glc 's coincide with the occurrence of neuronal damage. In addition, changes in cerebral blood flow are characterized by large increases up to 500% to 900% within seconds of the onset of seizure activity, and during this initial phase these large increases in rates of local cerebral blood flow (LCBF) are similar in amplitude to those of LCMR glc 's. However, as seizures continue, LCBF values decrease to 150% to 300% of control values after 1 or 2 hours of continuous seizure activity or SE, inducing a progressively established relative hypoperfusion, while the metabolic demand remains high. This situation may reach a critical level in terms of supplying adequate amounts ...