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Post-seizures amygdaloallocortical microvascular lesion leading to atrophy and memory impairment
Sima Mraovitch1, Yolande Calando, Angélique Régnier
1Laboratoire de Recherche Cérébrovasculaires CNRS URA 641, Université Paris VII, 10, av de Verdun, 75010 Paris, France. mraovit@ext.jussieu.fr
Insights
Generalized convulsive seizures can trigger multifocal brain hemorrhages and tissue damage, creating focal injury-prone areas (FIPA). This suggests seizures, not just cerebrovascular events, may initiate brain injury, necessitating comprehensive treatment strategies.
Area of Science:
- Neuroscience
- Pathology
- Cerebrovascular Medicine
Background:
- Seizures are recognized complications of cerebrovascular events like intracerebral hemorrhage.
- The precise mechanisms underlying seizure-induced brain injury, particularly hemorrhage, require further elucidation.
Purpose of the Study:
- To investigate the origin of multifocal amygdaloallocortical hemorrhage and tissue necrosis following generalized convulsive seizures.
- To identify the cellular and molecular events preceding seizure-induced brain injury.
Main Methods:
- Induction of generalized convulsive seizures via cholinergic stimulation of specific brain nuclei.
- Assessment of neuronal and microvascular changes, including COX-2 expression, pro-inflammatory cytokine presence (IL-1beta, TNF-alpha), edema, and microhemorrhages.
- Histopathological analysis to evaluate tissue necrosis, atrophy, and cognitive impairment.
Main Results:
- Generalized convulsive seizures induced multifocal amygdaloallocortical hemorrhage and necrosis, defining a focal injury-prone area (FIPA).
- Injury was preceded by reduced neuronal COX-2 and increased microvascular IL-1beta and TNF-alpha, indicating inflammation.
- Microvascular inflammation led to edema, microhemorrhages, subsequent atrophy, and cognitive deficits.
Conclusions:
- Generalized convulsive seizures can initiate amygdaloallocortical microvascular injury.
- This finding suggests seizures may be a primary cause of brain damage in some cerebrovascular accidents.
- Comprehensive clinical evaluation and therapy for seizure-associated cerebrovascular accidents, beyond anticonvulsants, are recommended.
Abstract:
Although the incidence of seizures after a cerebrovascular event including intracerebral hemorrhage has been widely recognized, the present studies have demonstrated that generalized convulsive seizures can cause multifocal amygdaloallocortical hemorrhage and tissue necrosis, the origin of which remains to be established. The seizure-elicited amygdaloallocortical injured area, which we refer to as a focal injury-prone area (FIPA), was caused by cholinergic stimulation of the ventroposterolateral and thalamic reticular nuclei. The amygdaloallocortical injury was preceded by focal absence of neuronal COX-2 and presence of microvascular immunoreactivity to the pro-inflammatory cytokines, IL-1beta and TNF-alpha. The microvascular inflammation was followed by edema and multifocal amygdaloallocortical microhemorrhages, leading to atrophy and cognitive impairment. On the basis of the present results, we conclude that generalized convulsive seizures may be at the origin of amygdaloallocortical microvascular injury suggesting that, in addition to anticonvulsant treatment, an appropriate clinical evaluation and therapy for seizures-associated cerebrovascular accidents should be considered.
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