Thus, two points of asymmetry can be found in the current study, one related to chronicity of seizures in humans vs. acute nature of BBB disruption-induced seizures, as well as the issue of human epileptic vs. normal brain induced to seize. In fact, to segregate and study drug resistant rats would constitute the best animal correlate of human multiple drug resistance to antiepileptic drugs. However, recent experimental findings suggested that correlates of acute seizures are not dissimilar from chronic seizures. For instance, seizures acutely induced by intrarterial mannitol have EEG features similar to pilocarpine seizure and the histological and immunohistochemical tracts of acute seizures are similar to the ones observed in the chronic epileptic human brain. Our results have shown that dexamethasone reduces the number of rats experiencing status epilepticus and abolishes mortality. The mechanism by which dexamethasone lessens pilocarpine seizure burden encompasses improved BBB function. This was shown by analysis of dye and marker extravasation in treated vs. untreated animals. We also studied the efficacy of addon gluco-corticosteroids in a population of pediatric drug resistant patients excluding those syndromes known to be responsive to GCs and ACTH. The effect was beneficial regardless of the pathology and epileptic syndrome. We have also reported a selected case where a decrease in FLAIR signal was Linolenic acid associated with seizure reduction. Previous studies have shown that FLAIR hyperintense regions or regions of gadolinium enhancement correspond to sites of BBB leakage. This manuscript presents findings in a format where clinical data are presented together with animal results. We believe that this is appropriate because: 1) there is a recognized urgency to provide rapid therapeutic advancement by comparing clinical and laboratory results ; 2) the anecdotal use of corticosteroids in clinical epilepsy has recently expanded, but its full potential for widespread use is limited by the lack of scientific validation of their use. Our study compared the efficacy of glucocorticosteroids and ATCH: 1) in patients across a wide NAEPA spectrum of epileptic etiologies and syndromes, 2) with the exclusion of those syndromes known to be steroid responsive.