Interweaving epilepsy and neurodegeneration: Vitamin E as a treatment approach

Biomed Pharmacother. 2021 Nov:143:112146. doi: 10.1016/j.biopha.2021.112146. Epub 2021 Sep 8.

Abstract

Epilepsy is the most common neurological disorder, affecting nearly 50 million people worldwide. The condition can be manifested either due to genetic predisposition or acquired from acute insult which leads to alteration of cellular and molecular mechanisms. Evaluating the latest and the current knowledge in regard to the mechanisms underlying molecular and cellular alteration, hyperexcitability is a consequence of an imbalanced state wherein enhance excitatory glutamatergic and reduced inhibitory GABAergic signaling is considered to be accountable for seizures associated damage. However, neurodegeneration contributing to epileptogenesis has become increasingly appreciated. The components at the helm of neurodegenerative alterations during epileptogenesis include GABAergic neuronal and receptor changes, neuroinflammation, alteration in axonal transport, oxidative stress, excitotoxicity, and other cellular as well as functional changes. Targeting neurodegeneration with vitamin E as an antioxidant, anti-inflammatory and neuroprotective may prove to be one of the therapeutic approaches useful in managing epilepsy. In this review, we discuss and converse about the seizure-induced episodes as a link for the development of neurodegenerative and pathological consequences of epilepsy. We also put forth a summary of the potential intervention with vitamin E therapy in the management of epilepsy.

Keywords: Epilepsy; Excitotoxicity; Neurodegeneration; Neuroinflammation; Oxidative stress; Vitamin E.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Inflammatory Agents / therapeutic use
  • Anticonvulsants / adverse effects
  • Anticonvulsants / therapeutic use*
  • Antioxidants / therapeutic use
  • Brain / drug effects*
  • Brain / metabolism
  • Brain / physiopathology
  • Brain Waves / drug effects*
  • Epilepsy / drug therapy*
  • Epilepsy / epidemiology
  • Epilepsy / metabolism
  • Epilepsy / physiopathology
  • Humans
  • Inflammation Mediators / metabolism
  • Nerve Degeneration*
  • Neurodegenerative Diseases / drug therapy*
  • Neurodegenerative Diseases / epidemiology
  • Neurodegenerative Diseases / metabolism
  • Neurodegenerative Diseases / physiopathology
  • Neuroprotective Agents / adverse effects
  • Neuroprotective Agents / therapeutic use*
  • Oxidative Stress / drug effects
  • Prognosis
  • Risk Assessment
  • Risk Factors
  • Signal Transduction
  • Vitamin E / adverse effects
  • Vitamin E / therapeutic use*

Substances

  • Anti-Inflammatory Agents
  • Anticonvulsants
  • Antioxidants
  • Inflammation Mediators
  • Neuroprotective Agents
  • Vitamin E