Therapeutic brain hypothermia, its mechanisms of action, and its prospects as a treatment for epilepsy

Authors

  • Gholam K. Motamedi,

    Corresponding author
    1. Department of Neurology, Georgetown University Hospital, Washington, District of Columbia, U.S.A
    • Address correspondence to Gholam K. Motamedi, Department of Neurology, PHC 7, Georgetown University Hospital, 3800 Reservoir Rd., NW, Washington, DC 20007, U.S.A. E-mail: motamedi@georgetown.edu

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  • Ronald P. Lesser,

    1. Department ofNeurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A.
    2. Department ofNeurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A.
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  • Stefano Vicini

    1. Department of Pharmacology & Physiology, Georgetown University School of Medicine, Washington, District of Columbia, U.S.A
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Summary

Cooling the core body temperature to 32–35°C, is almost standard practice for conditions such as cardiac arrest in adults, and perinatal hypoxic ischemic encephalopathy in neonates. Limited clinical data, and more extensive animal experiments, indicate that hypothermia could help control seizures, and could be applied directly to the brain using implantable devices. These data have fostered further research to evaluate whether cooling would be a viable means to treat refractory epilepsy. Although the effect of temperature on cellular physiology has long been recognized, with possibly dual effects on pyramidal cells and interneurons, the exact mechanisms underlying its beneficial effects, in particular in epilepsy, are yet to be discovered. This article reviews currently available clinical and laboratory data with a focus on cellular mechanisms of action and prospects of hypothermia as a treatment for intractable seizures.

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