Epileptic Seizures May Begin Hours in Advance of Clinical Onset: A Report of Five Patients

Mechanisms underlying seizure generation are traditionally thought to act over seconds to minutes before clinical seizure onset. We analyzed continuous 3- to 14-day intracranial EEG recordings from five patients with mesial temporal lobe epilepsy obtained during evaluation for epilepsy surgery. We f...

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Veröffentlicht in:Neuron (Cambridge, Mass.) Mass.), 2001-04, Vol.30 (1), p.51-64
Hauptverfasser: Litt, Brian, Esteller, Rosana, Echauz, Javier, D'Alessandro, Maryann, Shor, Rachel, Henry, Thomas, Pennell, Page, Epstein, Charles, Bakay, Roy, Dichter, Marc, Vachtsevanos, George
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container_title Neuron (Cambridge, Mass.)
container_volume 30
creator Litt, Brian
Esteller, Rosana
Echauz, Javier
D'Alessandro, Maryann
Shor, Rachel
Henry, Thomas
Pennell, Page
Epstein, Charles
Bakay, Roy
Dichter, Marc
Vachtsevanos, George
description Mechanisms underlying seizure generation are traditionally thought to act over seconds to minutes before clinical seizure onset. We analyzed continuous 3- to 14-day intracranial EEG recordings from five patients with mesial temporal lobe epilepsy obtained during evaluation for epilepsy surgery. We found localized quantitative EEG changes identifying prolonged bursts of complex epileptiform discharges that became more prevalent 7 hr before seizures and highly localized subclinical seizure-like activity that became more frequent 2 hr prior to seizure onset. Accumulated energy increased in the 50 min before seizure onset, compared to baseline. These observations, from a small number of patients, suggest that epileptic seizures may begin as a cascade of electrophysiological events that evolve over hours and that quantitative measures of preseizure electrical activity could possibly be used to predict seizures far in advance of clinical onset.
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subjects Action Potentials - physiology
Adult
Amygdala - pathology
Amygdala - physiopathology
Causality
Electrodes
Electroencephalography
Epilepsy, Temporal Lobe - pathology
Epilepsy, Temporal Lobe - physiopathology
Female
Hippocampus - pathology
Hippocampus - physiopathology
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Predictive Value of Tests
Temporal Lobe - pathology
Temporal Lobe - physiopathology
Time Factors
title Epileptic Seizures May Begin Hours in Advance of Clinical Onset: A Report of Five Patients
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