Seizure Termination

Zubler, Frédéric; Steimer, Andreas; Gast, Heidemarie; Schindler, Kaspar

doi:10.1016/b978-0-12-418693-4.00008-x

Cited by 25 publications

(19 citation statements)

References 73 publications

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“…Generally, seizure terminates automatically within a few minutes (Timofeev & Steriade, 2004;Lado & Mosh e, 2008;Zubler et al, 2014;Wang et al, 2015). This self-termination is often related to an increase in GABAergic inhibition (Lado & Mosh e, 2008).…”

Section: Discussionmentioning

confidence: 99%

Dynamics underlying interictal to ictal transition in temporal lobe epilepsy: insights from a neural mass model

Fan

Gaspard

Legros

et al. 2018

Eur J of Neuroscience

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We propose an approach that combines a neural mass model and clinical intracranial electroencephalographic (iEEG) recordings to explore the potential pathophysiological mechanisms (at the neuronal population level) of ictogenesis. Thirty iEEG recordings from 10 temporal lobe epilepsy (TLE) patients around seizure onset were investigated. Physiologically meaningful parameters [average excitatory (A ), slow (B), and fast (G) inhibitory synaptic gain] were identified during interictal to ictal transition. Four ratios (A /G, A /B, A /(B + G), and B/G) were derived from these parameters, and their evolution over time was analyzed. The excitation/inhibition ratio increased around seizure onset and decreased before seizure offset, indicating the impairment and re-emergence of excitation/inhibition balance around seizure onset and before seizure offset, respectively. Moreover, the slow inhibition may have an earlier effect on excitation/inhibition imbalance. We confirm the decrease in excitation/inhibition ratio upon seizure termination in human temporal lobe epilepsy, as revealed by optogenetic approaches both in vivo in animal models and in vitro. The increase in excitation/inhibition ratio around seizure occurrence could be an indicator to detect seizures.

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Section: Discussionmentioning

confidence: 99%

Dynamics underlying interictal to ictal transition in temporal lobe epilepsy: insights from a neural mass model

Fan

Gaspard

Legros

et al. 2018

Eur J of Neuroscience

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“…Several pathophysiologic mechanisms of seizure termination have been studied at the cellular/metabolic level including glutamate depletion [12], changes in ionic concentration [13, 14, 15], PH [14, 16]. Additionally modulatory effects from subcortical brain nuclei and cerebellum may be involved in seizure termination [16, 17]. At the network level multiple characteristics of neurophysiologic recordings have been quantitatively studied [17].…”

Section: Discussionmentioning

confidence: 99%

“…Additionally modulatory effects from subcortical brain nuclei and cerebellum may be involved in seizure termination [16, 17]. At the network level multiple characteristics of neurophysiologic recordings have been quantitatively studied [17]. Several proposed mechanisms suggest hypersynchronicity of epileptic activity.…”

Section: Discussionmentioning

confidence: 99%

Termination patterns of complex partial seizures: An intracranial EEG study

Afra

Jouny

Bergey

2015

Seizure

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Purpose While seizure onset patterns have been the subject of many reports, there have been few studies of seizure termination. In this study we report the incidence of synchronous and asynchronous termination patterns of partial seizures recorded with intracranial arrays. Methods Data were collected from patients with intractable complex partial seizures undergoing presurgical evaluations with intracranial electrodes. Patients with seizures originating from mesial temporal and neocortical regions were grouped into three groups based on patterns of seizure termination: synchronous only (So), asynchronous only (Ao), or mixed (S/A, with both synchronous and asynchronous termination patterns). Results 88% of the patients in the MT group had seizures with a synchronous pattern of termination exclusively (38%) or mixed (50%). 82% of the NC group had seizures with synchronous pattern of termination exclusively (52%) or mixed (30%). In the NC group, there was a significant difference of the range of seizure durations between So and Ao groups, with Ao exhibiting higher variability. Seizures with synchronous termination had low variability in both groups. Conclusions Synchronous seizure termination is a common pattern for complex partial seizures of both mesial temporal or neocortical onset. This may reflect stereotyped network behavior or dynamics at the seizure focus.

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“…The current review focus on the contribution of altered energy metabolism to seizure control. For reviews on other anticonvulsant mechanisms mediated by intrinsic ion-channel modifications, changes in functional, network and synaptic properties of the neurons and effects of neuromodulators see Löscher and Köhling (2010) and Zubler et al (2014) .…”

Section: Introductionmentioning

confidence: 99%

Bioenergetic Mechanisms of Seizure Control

Kovacs

Gerevich

Friedman

et al. 2018

Front. Cell. Neurosci.

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Epilepsy is characterized by the regular occurrence of seizures, which follow a stereotypical sequence of alterations in the electroencephalogram. Seizures are typically a self limiting phenomenon, concluding finally in the cessation of hypersynchronous activity and followed by a state of decreased neuronal excitability which might underlie the cognitive and psychological symptoms the patients experience in the wake of seizures. Many efforts have been devoted to understand how seizures spontaneously stop in hope to exploit this knowledge in anticonvulsant or neuroprotective therapies. Besides the alterations in ion-channels, transmitters and neuromodulators, the successive build up of disturbances in energy metabolism have been suggested as a mechanism for seizure termination. Energy metabolism and substrate supply of the brain are tightly regulated by different mechanisms called neurometabolic and neurovascular coupling. Here we summarize the current knowledge whether these mechanisms are sufficient to cover the energy demand of hypersynchronous activity and whether a mismatch between energy need and supply could contribute to seizure control.

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Seizure Termination

Cited by 25 publications

References 73 publications

Dynamics underlying interictal to ictal transition in temporal lobe epilepsy: insights from a neural mass model

Dynamics underlying interictal to ictal transition in temporal lobe epilepsy: insights from a neural mass model

Termination patterns of complex partial seizures: An intracranial EEG study

Bioenergetic Mechanisms of Seizure Control

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