Epileptic Seizures May Begin Hours in Advance of Clinical Onset: A Report of Five Patients*
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Research into mechanisms underlying seizure generation has traditionally focused on the seconds to at most few minutes before clinical seizure onset. In search of seizure predictors over longer periods of time, we analyzed continuous three to fourteen day EEG recordings from five consecutive patients with temporal lobe epilepsy implanted intracranially, with electrodes in and on the surface of the temporal lobes, during evaluation for epilepsy surgery. We found reliable, localized quantitative EEG changes, including increases in signal energy and brief bursts of rhythmic electrical discharges, indicating that epileptic seizures begin as a cascade of electrophysiological events that evolve over hours. Two important implications of these findings are: (1) neuroscientists investigating seizure generation must now focus on much longer time periods than were previously thought to be important to this process; and (2) an understanding of seizure precursors can be used to create implantable devices to forecast seizures and trigger intervention to prevent their electrical and clinical onset.
Keywords
Epileptic Seizure Temporal Lobe Epilepsy Seizure Onset Epilepsy Surgery Seizure GenerationPreview
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