Volume 47, Issue 11 pp. 1792-1802

Epidural Pentobarbital Delivery Can Prevent Locally Induced Neocortical Seizures in Rats: The Prospect of Transmeningeal Pharmacotherapy for Intractable Focal Epilepsy

Nandor Ludvig

Nandor Ludvig

Comprehensive Epilepsy Center, Department of Neurology, New York University School of Medicine, New York

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Ruben I. Kuzniecky

Ruben I. Kuzniecky

Comprehensive Epilepsy Center, Department of Neurology, New York University School of Medicine, New York

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Shirn L. Baptiste

Shirn L. Baptiste

Comprehensive Epilepsy Center, Department of Neurology, New York University School of Medicine, New York

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Jenine E. John

Jenine E. John

Comprehensive Epilepsy Center, Department of Neurology, New York University School of Medicine, New York

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Hans Von Gizycki

Hans Von Gizycki

Scientific Computing Center, SUNY Downstate Medical Center, Brooklyn, New York, U.S.A.

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Werner K. Doyle

Werner K. Doyle

Comprehensive Epilepsy Center, Department of Neurology, New York University School of Medicine, New York

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Orrin Devinsky

Orrin Devinsky

Comprehensive Epilepsy Center, Department of Neurology, New York University School of Medicine, New York

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First published: 02 October 2006
Citations: 29
Address correspondence and reprint requests to Dr. N. Ludvig at Comprehensive Epilepsy Center, Department of Neurology, NYU School of Medicine, 403 East 34th Street, 4th Floor, New York, NY, 10016 U.S.A. E-mail: [email protected]

Abstract

Summary: Purpose: To determine whether epidural pentobarbital (PB) delivery can prevent and/or terminate neocortical seizures induced by locally administered acetylcholine (Ach) in freely moving rats.

Methods: Rats were implanted permanently with an epidural cup placed over the right parietal cortex with intact dura mater. Epidural screw-electrodes, secured to the cup, recorded local neocortical EEG activity. In the seizure-termination study, Ach was delivered into the epidural cup, and after the development of electrographic and behavioral seizures, the Ach solution was replaced with either PB or artificial cerebrospinal fluid (aCSF; control solution). In the seizure-prevention study, the epidural Ach delivery was preceded by a 10-min exposure of the delivery site to PB or aCSF. Raw EEG recordings, EEG power spectra, and behavioral events were analyzed.

Results: Ach-induced EEG seizures associated with convulsions, which were unaffected by epidural aCSF applications, were terminated by epidurally delivered PB within 2–2.5 min. Epidural deliveries of PB before Ach applications completely prevented the development of electrographic and behavioral seizures, whereas similar deliveries of aCSF exerted no influence on the seizure-generating potential of Ach.

Conclusions: This study showed for the first time that epidural AED delivery can prevent, as well as terminate, locally induced neocortical seizures. The findings support the viability of transmeningeal pharmacotherapy for the treatment of intractable neocortical epilepsy.

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