Neuropathology of epilepsy

The effects of seizures on the brain are complex and have to be disentangled from the effects of any primary, underlying neurological disease process that has led to increased seizure susceptibility. Although there is evidence to support detrimental effects of seizures on brain histology, this is not inevitable1,2. Prolonged seizures may result in neuronal death by apoptotic (programmed or ‘active’) or necrotic pathways, as well as gliosis and microglial activation. Furthermore, injurious effects of seizures should be evaluated not only by histological changes, but at the subcellular, synaptic and molecular level. Neuropathological alterations may be adaptive and reversible while others are permanent.