Two things can happen after someone’s very first seizure. Nothing (preferable). Or the beginning of dangerous changes in the brain.
The term that describes the descent from a first seizure into epilepsy is epileptogenesis. There are some different theories as to what exactly happens that leads a previously healthy brain down the path of recurrent seizures.
uPersonally, I think that the oxidative stress generated from the seizure begins to destroy the ability of the brain to generate the energy it needs to function. Essentially the brain cells become “sick.” Since they were likely compromised in the first place, this makes it difficult for the epileptic patient to recover from without significant changes.
In other words–the lifestyle leading to poor brain health and the first seizure (stress, diet, environmental chemicals, sedentary lifestyles, etc…) is NOT going to be able to stop further degeneration in the brain cells. It’s going to require an overhaul of lifestyle at this point–an approach only rarely broached by neurologists.
Another theory on epileptogenesis is that changes occur to the DNA as a result of an initial seizure. As a quick background lesson, epigenetic changes are changes that occur, not to the DNA itself, but rather to the way DNA is accessed. Consider it much like a program on your computer–the same program can be personalized to have a purple background with orange font or white on black; it just depends on how you decide you want the program to look. It’s the same program either way.
In this model, after exposure to the initial seizure, the DNA of the brain cells begin to change in ways that make it more likely for future seizures to occur. Brain cells are known to do this–the firing of one pathway in the brain makes it easier to follow this same pathway again. Kind of like blazing a pathway or making a path.
This particular article delves into the concept of epigenetic changes leading to epilepsy. While a little technical, the gist of the study (done on rats) was that the use of adenosine was able to stop the process of epileptogenesis for at least 90 days. Adenosine is a molecule that helps to make up our DNA, but it also is a part of the all-important energy currency of our cells, ATP, produced in the mitochondria.
Overall, researchers were able to prove that providing adenosine directly to the region of the brain affected by that first seizure was able to halt the progression to epilepsy. They believe this occurred by blocking the process called methylation involved in epigenetic modification of the DNA. While powerful information, it is as of yet not applicable to humans, but opens up some powerful directions for researchers to take.
Interestingly, falling back onto MY personal theory, adenosine is an integral part of ATP (aka adenosine triphosphate) and levels of ATP are a major player in the proper functioning of brain cells. It is possible that the adenosine used in this study is working by a different mechanism that affecting DNA methylation. If this turns out to be the case, then lifestyle changes geared towards improving the health of the brian cells and increasing the amount of ATP in the brain cells may also play a role in derailing the progression to epilepsy.