Mild Brain Cooling After Injury Prevents Epileptic Seizures
December 7, 2012
Researchers at the University of Washington report in an upcoming issue of Annals of Neurology that mild cooling of the injured brain prevents the later development of epileptic seizures.
Epilepsy can either be genetic or acquired due to brain injury. Traumatic head injury is the leading cause of acquired epilepsy in young adults, and is often difficult to manage with available antiepileptic drugs. The mechanisms leading to the onset of epileptic seizures after brain injury are not known and there is currently no treatment to cure it, prevent it, or even limit its severity.
A University of Washington-led research team used a realistic rat model of acquired epilepsy in which animals develop chronic spontaneous recurrent seizures -the hallmark of epilepsy- after a contusive head injury similar to that causing epilepsy in humans. Animals were randomized to either mock-cooling or cooling of the contused brain by no more than 2 Celsius degrees. This degree of cooling, the authors say, is known to be safe and to decrease mortality of patients with head injury. Animals were then monitored for 4 months after injury and epilepsy was evaluated by intracranial EEG.
The contused brain was cooled continuously with special headsets engineered to passively dissipate heat. No Peltier cells or other power sources for refrigeration were needed.
The investigators report that cooling by just 2 celsius degrees for 5 weeks beginning 3 days after injury virtually abolished the later development of epileptic seizure activity. This effect persisted through the end of the study. The treatment induced no additional pathology or inflammation, and restored neuronal activity depressed by the injury.
These findings demonstrate for the first time that prevention of epileptic seizures after traumatic brain brain injury is possible, and that epilepsy prophylaxis in patients could be achieved more easily than previously thought. A clinical trial is required to verify the findings in head injury patients.
The project was led by Dr. Raimondo D'Ambrosio, cellular electrophysiologist, and involved Drs. John W. Miller and Steven M. Rothman, epileptologists, Dr. Nancy R. Temkin, biostatistician, and Drs. Jeffrey G.
Ojemann and Matthew D. Smyth, neurosurgeons.
The results of the study are published in the Annals of Neurology.