Role of blood-brain barrier in temporal lobe epilepsy and pharmacoresistance.

Temporal lobe epilepsy (TLE) is the most common form of focal epilepsies in adults. It is often initiated by an insult or brain injury which triggers a series of alterations which ultimately lead to seizures (epilepsy). In 50-70% of people with TLE the condition cannot be adequately treated by the present antiepileptic drugs. During the last decade the blood-brain barrier (BBB) has received renewed interest as a potential target to treat TLE or its progression. BBB changes have been observed in brain tissue of people with epilepsy as well as in experimental models at the structural, cellular and molecular level that could explain its role in the development and progression of epilepsy (epileptogenesis) as well as the development of drug resistance. Here, we will discuss the role of the BBB in TLE and drug resistance and summarize potential new therapies that may restore normal BBB function in order to put a brake on epileptogenesis and/or to improve drug treatment.