25 Epilepsy and Adult Neurogenesis

The epilepsies are a diverse group of neurological disorders that share the central feature of spontaneous recurrent seizures. Some epilepsies result from inherited mutations in single or multiple genes, termed idiopathic or primary epilepsies, whereas symptomatic or secondary epilepsies develop as a consequence of acquired brain abnormalities such as from tumor, trauma, stroke, infection, or developmental malformation. Of acquired epilepsies, mesial temporal lobe epilepsy (mTLE) is a particularly common and often intractable form. In addition to pharmacoresistant seizures, the syndrome of mTLE almost always involves impairments in cognitive function (Helmstaedter 2002; Elger et al. 2004; von Lehe et al. 2006) that may progress even with adequate seizure control (Blume 2006). Seizure activity from mTLE typically arises from the hippocampus or other mesial temporal lobe structures. Simple and complex partial seizures, the most common seizure types in this epilepsy syndrome, often become medically refractory and may respond only to surgical resection of the epileptogenic tissue. Hippocampi in these cases usually show substantial structural abnormalities that include pyramidal cell loss, astrogliosis, dentate granule cell axonal reorganization (mossy fiber sprouting), and dispersion of the granule cell layer (Blumcke et al. 1999). Humans with mTLE often have a history of an early “precipitating” insult, such as a prolonged or complicated febrile seizure, followed by a latent period and then the development of epilepsy in later childhood or adolescence. These historical findings have led to the development of what are currently the most common animal models, the status epilepticus (SE) models, used to study epileptogenic...