Programmed Necrosis After Status Epilepticus

Excerpt

We review recent progress in the field of seizure-induced neuronal injury. Clinical data suggest that seizures trigger neuronal death, but its mechanism is not well understood. We are beginning to understand the role of neuronal necrosis, the dominant form of death in the adult brain. In a postnatal model of status epilepticus (SE), apoptosis is mainly found in immature neurons, while necrosis is the main form of death in mature neurons, suggesting that the degree of maturity of individual neurons is more important that the level of maturity of the whole organism in determining the mode of neuronal death induced by seizures. It is traditionally thought that necrosis is a passive process which does not require the activation of orderly cell death program(s). Experimental models of SE helped elucidating the contribution of cell death pathways in some active forms of necrosis. SE-induced neuronal necrosis can be an active mechanism requiring the execution of a mitochondrial death program and/or the activation of a caspase cascade. Altogether, these data suggest that the neuronal death landscape is complex and redundant, and that successfully targeting cell death pathways may require polytherapy.