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Neuropathology of Generalized Convulsive Status Epilepticus

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Status Epilepticus

Part of the book series: Current Clinical Neurology ((CCNEU))

Abstract

Generalized convulsive status epilepticus is a life-threatening condition with high mortality; it also causes cellular damage. Systemic physiologic changes in blood pressure, oxygenation, and temperature can cause widespread neuronal injury, but even when systemic physiologic parameters are controlled, status epilepticus can cause focal cell loss in the hippocampus. There is progressive loss of GABAergic inhibitory neurotransmission and sustained glutamatergic excitatory neurotransmission during the course of status epilepticus. Glutamate-mediated excitotoxicity is the most likely cause of focal neuronal injury. If status epilepticus continues for more than an hour, these changes can eventually result in hippocampal cell death, probably because N-methyl-d-aspartate (NMDA) glutamate receptors are concentrated in this region. The pattern of cell loss is similar to hypoxic cell damage but is also distinct and identical to the pattern of cell loss found in medial temporal lobe epilepsy due to hippocampal sclerosis. Early treatment of status epilepticus is necessary to prevent irreversible neuronal injury and cell death.

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  1. Department of Neurology, University of Virginia, Box 800394, Charlottesville, VA, 22908, USA

    Nathan B. Fountain & Suchitra Joshi

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Correspondence to Nathan B. Fountain .

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  1. Department of Neurology, Harvard Medical School, Comprehensive Epilepsy Center, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA

    Frank W. Drislane

  2. Department of Neurology, Johns Hopkins Bayview Medical Center, Baltimore, Maryland, USA

    Peter W. Kaplan MBBS

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Fountain, N.B., Joshi, S. (2018). Neuropathology of Generalized Convulsive Status Epilepticus. In: Drislane, F., Kaplan MBBS, P. (eds) Status Epilepticus. Current Clinical Neurology. Springer, Cham. https://doi.org/10.1007/978-3-319-58200-9_10

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