Local delivery strategies in epilepsy; a focus on adenosine

Local delivery of compounds directly into the brain may become an attractive treatment option for several neurological diseases. Higher therapeutic drug levels may be reached at the targeted brain region and in this way systemic side effects avoided. This paper provides an overview of the currently investigated experimental and clinical local delivery strategies in the brain ranging from delivery via pump mechanisms to more advanced techniques with cell and gene therapy. The second part focuses on local brain delivery strategies for epilepsy with special attention to adenosine. Adenosine is a good candidate for local delivery techniques for epilepsy because of its proven anticonvulsive effect and it cannot be given systemically because of systemic side effects. An overview of the current published studies with local delivery of adenosine is given. (C) 2011 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.