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. 2021 Jul 12;15:708304. doi: 10.3389/fnins.2021.708304

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Copyright © 2021 Purnell, Murugan, Jani and Boison.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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The good, the bad, and the deadly effects of adenosine during seizures. The multifaceted roles of adenosine homeostasis during seizures is highlighted. The beneficial/good aspects include (i) seizure termination, (ii) neuroprotection against hypoxia, (iii) increased vasodilation, and (iv) prevention of epileptogenesis. The detrimental/bad aspects include (i) suppression of breathing, (ii) PGES, (iii) worsened electrographic dysfunction following spreading depolarization, and (iv) development of sleep deficits. Excessive adenosine release or insufficient adenosine clearance may result in a deadly outcome in the form of SUDEP.