title: [The cortico-thalamic theory for generalised spike-wave discharges].
abstract: The origin of generalized absence epilepsy is still not known. In the last century, four theories have dominated the debate about the origin of the bilateral synchronous generalized spike-wave discharges associated with absence seizures: the "centrencephalic" theory [Penfield and Jasper], the "cortical" [Bancaud, Niedermeyer, Luders], the "cortico-reticular" theory [Gloor, Kostop[oulos, Avoli] and the "thalamic clock" theory [Buzsaki]. There is now some evidence that absence epilepsy, as studied in the WAG/Rij model, is a corticothalamic type of epilepsy. A new hypothesis is proposed which suggests that a cortical focus in the somatosensory cortex is driving the widespread corticothalamic networks during spontaneous absence seizures. This modern theory was given the name "hot spot' theory" [Meeren et al., 2002]. According to the present view three brain structures are critically involved and their integrity seems a minimal and sufficient condition for the occurrence of spike-wave discharges. Firstly, the reticular thalamic nucleus is involved and most likely its rostral pole. Secondly, the thalamocortical relay cells in the ventrobasal complex play a role and, thirdly and most importantly, the cerebral cortex with its epileptic zone. The zone in which the epileptic focus seems to be localised is located on the somato-sensory cortex, and more precisely in the area on which the peri-oral region including the upper lip, projects.
authors.affiliation: MEG Centre, Free University Medical Centre, Amsterdam, The Netherlands.
authors.forename: H K M
authors.initials: HK
authors.lastname: Meeren
authors.forename: E L J M
authors.initials: EL
authors.lastname: van Luijtelaar
authors.forename: F H
authors.initials: FH
authors.lastname: Lopes da Silva
authors.forename: R K
authors.initials: RK
authors.lastname: Berdiev
authors.forename: N E
authors.initials: NE
authors.lastname: Chepurnova
authors.forename: S A
authors.initials: SA
authors.lastname: Chepurnov
authors.forename: A M L
authors.initials: AM
authors.lastname: Coenen
mesh_terms: D000818:Animals; D001921:Brain / Q000503:physiopathology; D002540:Cerebral Cortex / Q000503:physiopathology*; D004195:Disease Models, Animal; D004832:Epilepsy, Absence / Q000503:physiopathology*; D006801:Humans; D020646:Intralaminar Thalamic Nuclei / Q000503:physiopathology; D051381:Rats; D013788:Thalamus / Q000503:physiopathology*