Neuroinflammation as a Causal Factor in Post-Traumatic Epilepsy: A Comprehensive Review of Pathobiology, Biomarkers, and Therapeutic Repurposing

Introduction: Post-Traumatic Epilepsy (PTE) is a prevalent but understudied condition resulting from Traumatic Brain Injury (TBI). Surprisingly, over a third of PTE patients do not respond to conventional Antiepileptic Drugs (AEDs). Predicting and prognosticating PTE is challenging due to limited knowledge of its etiology. This paper reviews existing literature to explore the causal link between neuroinflammation and PTE, identifies biomarkers for clinical prediction and prognosis, seeks to enhance treatment options, and aims to contribute to the knowledge base of this condition.

Methods: We conducted an extensive review of articles using keywords such as 'post-traumatic epilepsy,' 'causal roles,' 'neuroinflammation,' 'predicting and prognosticating,' 'repurposing known drugs,' and 'clinical biomarkers' on research databases, including Google Scholar and PubMed. After a preliminary review, we selected relevant papers for in-depth analysis and explored additional sources from their references.

Results: PTE was confirmed as a commonly acquired form of epilepsy with distinct pathobiology, differentiating it from other genetic or Temporal Lobe Epilepsy forms. The causal role of neuroinflammation in PTE was delineated, with clinical biomarkers using pro-inflammatory cytokines and chemokines identified. Several well-known drugs were reviewed as potential substitutes for AEDs, aiming to improve clinical outcomes and overcome resistance to conventional treatments.

Conclusion : PTE is a prevalent form of epilepsy, but the clinical outcomes remain unsatisfactory. Based on our findings, it is imperative to intensify research efforts to expand our knowledge base, offering a broader array of treatment options and improving clinical outcomes for PTE patients.