Reply: Complexities in the association of human blood brain barrier disruption with seizures: importance of patient population and method of disruption

We recently reported that epileptic seizures might be facilitated through the action of blood–proteins that leak into the CNS during the chronic epileptic phase in rats (Van Vliet et al ., 2007). This was further supported by our mannitol experiments in epileptic rats which showed increased seizure progression in a subgroup of rats. Mannitol can be used to open the blood–brain barrier (BBB) by producing osmotic shrinking of the endothelial cells and mechanical separation of the tight junctions that form the BBB. Therefore mannitol can be used to deliver various drugs directly to the brain. Previous studies by Neuwelt et al . (Neuwelt et al ., 1983, 1986; Roman-Goldstein et al ., 1994) pointed to the fact that seizures could be one of the complicating factors when patients with brain tumours were treated with …