Neurosteroids And Epileptogenesis

The review article explored the role of neurosteroids in epileptogenesis, particularly focusing on the latent period before spontaneous recurrent seizures occur and the progression of epilepsy in pharmacoresistant patients. It highlighted the involvement of neuroinflammation and gliosis in epilepsy, with a specific focus on the up-regulation of the cytochrome P450 cholesterol side-chain cleavage (P450scc) enzyme in glial cells, which is crucial for neurosteroid synthesis. In rat models, increased P450scc expression was linked to delayed seizure onset, while the administration of finasteride, a 5α-reductase blocker, shortened the latent period and promoted seizures, indicating that neurosteroids like allopregnanolone play a protective role. Similar exacerbation of epilepsy was observed in humans exposed to finasteride, suggesting that neurosteroids may have an antiepileptogenic effect.