Toward a Mechanistic Understanding of Epileptic Networks.
Focal epileptic seizures have long been considered to arise from a small susceptible brain area and spread through uninvolved regions. In the past decade, the idea that focal seizures instead arise from coordinated activity across large-scale epileptic networks has become widely accepted. Understanding the network model's applicability is critical, due to its increasing influence on clinical research and surgical treatment paradigms. In this review, we examine the origins of the concept of epileptic networks as the nidus for recurring seizures. We summarize analytical and methodological elements of epileptic network studies and discuss findings from recent detailed electrophysiological investigations. Our review highlights the strengths and limitations of the epileptic network theory as a metaphor for the complex interactions that occur during seizures. We present lines of investigation that may usefully probe these interactions and thus serve to advance our understanding of the long-range effects of epileptiform activity.
Department of Neurological Surgery, Columbia University Medical Center, New York, NY, 10032, USA.
Elliot H
EH
Smith
Department of Neurology, Columbia University Medical Center, New York, NY, 10032, USA. cas2044@cumc.columbia.edu.|Neurological Institute, 710 West 168th Street, New York, NY, 10032, USA. cas2044@cumc.columbia.edu.
Catherine A
CA
Schevon
D000818:Animals; D004569:Electroencephalography; D004827:Epilepsy / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D008866:Microsurgery; D012640:Seizures; D013997:Time Factors
EEG; Epilepsy; Epilepsy surgery; Epileptic networks; Seizure localization; Seizures
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