Table 1.
Drugs and interventions used to control status epilepticus have anti-inflammatory effects that may result in blood-brain barrier protection/repairing
Therapeutic intervention | Classification/Drug class | Accepted mechanism of action | Anti-inflammatory potency | Predicted or demonstrated effects on BBB integrity | References |
---|---|---|---|---|---|
Propofol | Anaesthetic | ||||
Short-acting hypnotic agent | GABA | Inhibits NF-κB | Protection/repair | Jaaskelainen et al., 2003; Sanchez-Conde et al., 2008; Schneemilch et al., 2005 | |
Thiopental | Anaesthetic | ||||
Short-acting hypnotic agent | GABA | Inhibits NF-κB | Protection/repair | Roesslein et al., 2008; Schneemilch et al., 2005 | |
Ketamine | Anaesthetic | ||||
Dissociating anaesthetic | NMDA antagonist | Inhibits NF-κB and IL-1β, TNF-α surge | Protection/repair | Beilin et al., 2007; Welters et al., 2010, 2011; | |
Magnesium | Electrolyte | ||||
NMDA blocker | NA | Restores NMDA receptor blockade after BBB disruption | Amtorp and Sorensen, 1974; Heath and Vink, 1998 | ||
Vagal nerve stimulator | Device | ||||
Unknown | Nicotinic receptors Ghrelin | Protection/repair | Cheyuo et al., 2011; Rosas-Ballina and Tracey, 2009; Rosas-Ballina et al., 2011 | ||
Ketogenic diet | Dietary regimen | ||||
Unknown | NA | Protection/repair | Janigro, 1999; Nabbout et al., 2011 | ||
Hypothermia | Medical management | ||||
Unknown | Inhibits NF-κB | Protection/repair | Oztas and Kaya, 1994; Polderman, 2009; Webster et al., 2009 | ||
Cortico-steroids | Anti-inflammatory agents | ||||
Immunodepression | Similar to NFκB inhibition | Protection/repair | Marchi et al., 2009, 2011 |
BBB = blood–brain barrier; NMDA = N-methyl-d-aspartic acid; Nf-κb = nuclear factor kappa B; IL = interleukin; TNF = tumor necrosis factor; NA = not available.