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2018;4:609-616.doi:10.1016/j.trci.2018.09.009 Roberts VH, Pound LD, Thorn SR, etal

For example, proinflammatory cytokines such as IL-1 have been shown to impair neurotransmitter homeostasis (e.g., decreased serotonin levels and enhanced glutamatergic excitotoxicity), induce oxidative stress (OS) and neuronal pyroptosis, and lead to mitochondrial dysfunction and synaptic protein lossultimately fostering a bidirectional relationship between epilepsy and depression (Zhu et al., 2006

But its also the stage that requires the most careful investigation, because removing the wrong things or missing the real triggers entirely means the subsequent steps are building on an unstable foundation

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