Human and animal EEG data demonstrate that focal seizures start with low-voltage fast activity, evolve into rhythmic burst discharges and are followed by a period of suppressed background activity. This suggests that processes with dynamics in the range of tens of seconds govern focal seizure evolution. We investigate the processes associated with seizure dynamics by complementing the Hodgkin-Huxley mathematical model with the physical laws that dictate ion movement and maintain ionic gradients. Our biophysically realistic computational model closely replicates the electrographic pattern of a typical human focal seizure characterized by low voltage fast activity onset, tonic phase, clonic phase and postictal suppression. Our study demonstrates, for the first time in silico, the potential mechanism of seizure initiation by inhibitory interneurons via the initial build-up of extracellular K due to intense interneuronal spiking. The model also identifies ionic mechanisms that may underlie a key feature in seizure dynamics, that is, progressive slowing down of ictal discharges towards the end of seizure. Our model prediction of specific scaling of inter-burst intervals is confirmed by seizure data recorded in the whole guinea pig brain in vitro and in humans, suggesting that the observed termination pattern may hold across different species. Our results emphasize ionic dynamics as elementary processes behind seizure generation and indicate targets for new therapeutic strategies.
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http://dx.doi.org/10.7554/eLife.68541 | DOI Listing |
J Neurosci
January 2025
Department of Neuroscience, Brown University, Providence RI, USA.
Voltage-gated potassium conductances [Formula: see text] play a critical role not only in normal neural function, but also in many neurological disorders and related therapeutic interventions. In particular, in an important animal model of epileptic seizures, 4-aminopyridine (4-AP) administration is thought to induce seizures by reducing [Formula: see text] in cortex and other brain areas. Interestingly, 4-AP has also been useful in the treatment of neurological disorders such as multiple sclerosis (MS) and spinal cord injury, where it is thought to improve action potential propagation in axonal fibers.
View Article and Find Full Text PDFBMJ Case Rep
January 2025
Clinical Pharmacology, Aalborg University Hospital, Aalborg, Region Nordjylland, Denmark
A middle childhood boy with epilepsy exhibited persistent low concentrations of valproic acid, lamotrigine and topiramate for over 1 month, primarily due to pharmacokinetic interactions involving fosphenytoin, meropenem and phenobarbital. Awareness of these clinically significant interactions is crucial for ensuring effective seizure control. However, further research is needed to establish optimal evidence-based treatment strategies in complex paediatric cases.
View Article and Find Full Text PDFAnn Vasc Surg
January 2025
Vascular and Endovascular Surgery, University of Miami School of Medicine, Miami, Florida. Electronic address:
Background: Cerebral hyperperfusion syndrome (CHS) is a rare but serious complication after carotid artery revascularization. This study aims to determine the impact of carotid artery stenting (CAS) modality on the incidence, severity and overall outcomes of CHS after carotid revascularization.
Methods: Data from patients who underwent CAS with either distal embolic protection (CAS+DEP) or transcarotid artery revascularization (TCAR) were obtained from the Vascular Quality Initiative (VQI) database 2016-2023.
Epilepsy Behav
January 2025
Royal Perth Hospital, Victoria Square, Perth, WA 6000, Australia; The University of Western Australia, 35 Stirling Hwy, Crawley, WA 6009, Australia.
Objectives: To evaluate the availability and consistency of commercial driving eligibility criteria for patients with seizures.
Methods: We systematically evaluated commercial driver's license regulations for patients with epilepsy, first acute symptomatic seizure and first unprovoked seizure in different countries. Government driving authority websites and published guidelines were accessed and if not available, local neurologists were contacted.
Epilepsy Res
January 2025
Epilepsy Program, Division of Neurology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. Electronic address:
Background: Direct cortical electrical stimulation remains the gold standard for delineation of the primary motor cortex in patients with drug-resistant epilepsy (DRE) undergoing epilepsy surgery evaluation OBJECTIVE: This study aimed to explore the efficacy and safety of functional motor mapping through Stereo-EEG (SEEG) electrode contacts in children with DRE at our institute.
Methods: We performed a retrospective analysis of children who underwent SEEG evaluation and functional cortical mapping via bipolar electrical stimulation at our institution between July 2020 and June 2024. Detailed clinical, radiological and neurophysiological variable were extracted; qualitative and quantitative variables were summarized using appropriate descriptive statistics.
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