Archive 1995–2023

In recent years, the infl ammatory reactions and the associated disturbance of the blood-brain barrier integrity have been found to affect the course of the disease and the response to treatment in both the experimental models as well as in patients with epilepsy. Increased permeability of the blood-brain barrier causes the influx of leukocytes and the accumulation of albumin leading to the activation of glial cells. Glial cells, through secreted chemokines and cytokines (e.g. IL1β, IL6, TNFα) activate the endothelium. Moreover, proinfl ammatory factors are involved in the mechanism of neuronal hyperexcitability, including interactions with the neurotransmitter systems (e.g. glutamate, GABA) and the modifi cation of the external environment of the nerve cells, which consequently leads to the formation of seizures. The interaction between the blood-brain barrier and the glial cells may represent a new therapeutic target for the treatment of refractory epilepsy.