Epilepsy Talk

Kindling — Using Seizures to End Seizures | August 31, 2011

When you think of “kindling,” think of confusing. Controversy. Cure.

No, it’s not the little twigs for a bonfire! But the name “kindling” was inspired by a log fire. The log many be suitable for a fire, but alone, it’s difficult to get a flame going. But add some smaller, light pieces of wood (“kindling”) and set them on fire and soon the log will be blazing.

And this blazing fire has been at the center of epilepsy research for more than three decades. Its purpose? To provide key insights into seizures and epilepsy. It remains a mainstay of epilepsy related research, but the question remains how the results from kindling experiments further our understanding of the underlying neurobiology of human epilepsy. That answer to that question remains elusive.

Perhaps it’s because the kindling theory is a convenient explanation for the recurrent nature of many neuropsychiatric illnesses…

Kindling occurs at all ages. It can be caused by stress (like everything else), environment, even chemicals.

In the beginning, the episodes are stimulus-dependent with results appearing in only brief electrical discharges and mild behavioral changes. Then they reappear when provoked. And with each recurrence, the neural systems fire up a little more easily, until they have a life of their own. Ultimately, they begin to appear without the incendiary stimulus and result in more prolonged and intense electrical and behavioral seizures.

The seizure trigger areas are located in the temporal lobes, along the sides of the brain, which is the most common form of epilepsy and the most difficult to treat. The stimulation of the brain by brief low-intensity electrical current or pharmacological agents, in turn, produces seizure behavior of gradually increasing intensity that ultimately culminates in a full, clonic, motor seizure.

Interestingly, the impact of these persistent biochemical and physiological alterations that accompany kindling, may influence behavior for a long period of time, despite the absence of further seizure stimulation. The sensitivity of limbic structures to kindling may contribute to this behavior and cognitive qualities that are particularly influenced by the kindling process.

It has been reported that repeated seizure stimulation can result in spontaneous seizures, but studies have had conflicting findings on this question. In humans, some seizure disorders come to an end by themselves even after large numbers of seizures. However, in both human epilepsy and in some animal models, evidence suggests that a process like that found in kindling may also fail to stop seizures.

Think of it as fighting fire with fire.

While science has not unlocked all the secrets of brain function to date, we do know that the brain is flexible and adaptable. It grows new neuronal pathways to process information or thoughts. This is important with regards to seizures in that the brain can “learn to seize” via kindling — if seizures are allowed to continue uncontrolled. It also offers hope though that the brain can learn how to function without seizing when seizures are fully controlled for several years. (2 years is usually the milestone where neurologists may test for normalized brain function to possibly reduce/eliminate medications.)

So although there’s controversy, there’s promise. After all, kindling wouldn’t have lasted for three decades if it was a useless science. From it we can learn. And hope. And as ridiculous as it may seem: seizures may actually prevent future seizures!  

Resources:

http://bipolar.about.com/cs/brainchemistry/a/0009_kindling1.htm

http://www.gwwoundcare.info/health-and-healthcare/news_the-kindling-theory.html

http://en.wikipedia.org/wiki/Kindling_model

http://www.lindane.org/health/toxicology/seizures.htm

http://braincanada.ca/en/Neuroscience_Canada

http://medical-dictionary.thefreedictionary.com/kindling

http://ebooks.worldscinet.com/ISBN/9789812819819/9789812819819_0016.html

http://psycnet.apa.org/psycinfo/2007-09512-003

http://www.answers.com/topic/kindling-model

http://www.coping-with-epilepsy.com/forums/f22/unkindling-behavior-mod-seizure-control-1682/

http://professionals.epilepsy.com/page/childhood_recur.html

http://www.ncbi.nlm.nih.gov/pubmed/17571354

 

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