Initiation, Propagation, and Termination of Partial (Focal) Seizures

  1. Massimo Avoli2,3
  1. 1Unit of Epileptology and Experimental Neurophysiology and Fondazione Istituto Neurologico Carlo Besta, 20133 Milano, Italy
  2. 2Montreal Neurological Institute and Departments of Neurology and Neurosurgery and Physiology, McGill University, Montréal, H3A 2B4 Québec, Canada
  3. 3Department of Experimental Medicine, Facoltà di Medicina e Odontoiatria, Sapienza Università di Roma, 00185 Roma, Italy
  1. Correspondence: decurtis{at}istituto-besta.it

Abstract

The neurophysiological patterns that correlate with partial (focal) seizures are well defined in humans by standard electroencephalogram (EEG) and presurgical depth electrode recordings. Seizure patterns with similar features are reproduced in animal models of partial seizures and epilepsy. However, the network determinants that support interictal spikes, as well as the initiation, progression, and termination of seizures, are still elusive. Recent findings show that inhibitory networks are prominently involved at the onset of these seizures, and that extracellular changes in potassium contribute to initiate and sustain seizure progression. The end of a partial seizure correlates with an increase in network synchronization, which possibly involves both excitatory and inhibitory mechanisms.

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