The blood-brain barrier hypothesis in drug resistant epilepsy

Sir, We read with great interest this succinct, informative and focused update on the therapeutic approach to super-refractory status epilepticus (SRSE) by Shorvon and Ferlisi (2011). In particular, we were pleased to see the ‘blood–brain barrier failure’ displayed as a potential seizurogenic mechanism. The authors provide a comprehensive update on the treatment options, and a thoughtful rationale for the timing of interventions. We noted that the authors present in Fig. 1 and Table 1 a number of anti-SRSE choices spanning from drugs acting on γ-aminobutyric acid (GABA) receptors (benzodiazepines, anaesthetics and barbiturates) to anti-inflammatory drugs (corticosteroids) or to other treatments with direct or indirect, documented or unknown, mechanisms of action on neurons. View this table:Table 1 Drugs and interventions used to control status epilepticus have …