Mammalian target of rapamycin (mTOR) activation in focal cortical dysplasia and related focal cortical malformations

Focal cortical dysplasia (FCD) and other localized malformations of cortical development represent common causes of intractable pediatric epilepsy. Insights into the cellular and molecular pathogenesis of focal cortical malformations may reveal information about associated mechanisms of epileptogenesis and suggest new therapies for seizures caused by these developmental lesions. In animal models and human studies of FCD and the related disease of Tuberous Sclerosis Complex (TSC), the mammalian target of rapamycin (mTOR) pathway has been implicated in mediating cellular and molecular changes leading to the formation of the cortical malformations and the expression of epilepsy. The use of mTOR inhibitors may represent a rational therapeutic strategy for treating or even preventing epilepsy due to FCD and TSC.

► Focal cortical dysplasia and tuberous sclerosis are common causes of intractable epilepsy.
► These focal cortical malformations have similar pathological and cellular abnormalities.
► mTOR pathway signaling may promote the pathogenesis of focal cortical malformations.
► mTOR pathway signaling may promote epileptogenesis in focal cortical malformations.
► mTOR inhibitors may be a rational therapy for epilepsy in focal cortical malformations.