2017
DOI: 10.1111/epi.13827
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Postictal hypoperfusion/hypoxia provides the foundation for a unified theory of seizure‐induced brain abnormalities and behavioral dysfunction

Abstract: A recent article by Farrell et al. characterizes the phenomenon, mechanisms, and treatment of a local and severe hypoperfusion/hypoxia event that occurs in brain regions following a focal seizure. Given the well-established role of cerebral ischemia/hypoxia in brain damage and behavioral dysfunction in other clinical settings (e.g., stroke, cerebral vasospasm), we put forward a new theory: postictal hypoperfusion/hypoxia is responsible for the negative consequences associated with seizures. Fortunately, inhibi… Show more

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Cited by 83 publications
(87 citation statements)
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“…Conversely, despite the seizure‐induced neurovascular decoupling, we never observed tissue oxygenation below the normoxic range (>20 mm Hg) during recurrent seizures in vivo. These results are in apparent contradiction to previous studies reporting local postictal hypoxia and vasoconstriction with optical methods (for review, see Suh et al). This discrepancy could be explained by the lower spatial resolution (~60 μm) of the Clark‐style microelectrodes used in our study, by the different models of epileptogenesis, or by the use of the open window technique and perfusion with gassed aCSF.…”
Section: Discussioncontrasting
confidence: 99%
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“…Conversely, despite the seizure‐induced neurovascular decoupling, we never observed tissue oxygenation below the normoxic range (>20 mm Hg) during recurrent seizures in vivo. These results are in apparent contradiction to previous studies reporting local postictal hypoxia and vasoconstriction with optical methods (for review, see Suh et al). This discrepancy could be explained by the lower spatial resolution (~60 μm) of the Clark‐style microelectrodes used in our study, by the different models of epileptogenesis, or by the use of the open window technique and perfusion with gassed aCSF.…”
Section: Discussioncontrasting
confidence: 99%
“…Seizure‐induced capillary constriction was accompanied by loss of mitochondrial integrity in pericytes, highlighting the role of energy metabolism in microvascular injury. Our findings may help understand the mechanisms behind the postictal microcirculatory hypoperfusion underlying behavioral and cognitive symptoms associated with seizure disorders …”
Section: Discussionmentioning
confidence: 91%
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