Basic mechanisms of seizure expression.
While there are many types of seizures, our understanding of their pathophysiology is limited to a few types. On the basis of the behavior of neurons during a seizure, two fundamental types of paroxysms are recognized--spike-wave electrographic seizures and tonic-clonic electrographic seizures. When the former type of paroxysm takes place throughout the forebrain, an absence seizure ensues. When the latter type of paroxysm takes place within a limited set of neurons, a simple partial or complex partial seizure takes place, depending on the functional anatomy. When the latter type of paroxysm takes place throughout the forebrain, a generalized convulsion takes place. The basic cellular and synaptic processes that underlie electrographic spike-wave and tonic-clonic paroxysms are complex and dissimilar between the two types of discharges. This paper reviews these multiple processes. The diverse pathophysiological mechanisms presented provide a theoretical substrate for rational polypharmacy directed to seizure suppression.
Lothman
E W
EW
Department of Neurology, University of Virginia Health Sciences Center, Charlottesville 22908, USA.
D000818:Animals; D001921:Brain / Q000503:physiopathology*; D004569:Electroencephalography; D004827:Epilepsy / Q000145:classification / Q000503:physiopathology*; D004832:Epilepsy, Absence / Q000145:classification / Q000503:physiopathology; D017029:Epilepsy, Complex Partial / Q000145:classification / Q000503:physiopathology; D004829:Epilepsy, Generalized / Q000145:classification / Q000503:physiopathology; D004830:Epilepsy, Tonic-Clonic / Q000145:classification / Q000503:physiopathology; D005071:Evoked Potentials / Q000502:physiology; D006801:Humans; D009474:Neurons / Q000502:physiology; D016548:Prosencephalon / Q000503:physiopathology; D009435:Synaptic Transmission / Q000502:physiology*