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

  • Brian Litt
  • Rosana Esteller
  • Javier Echauz
  • Maryann D'Alessandro
  • Rachel Shor
  • Thomas Henry
  • Page Pennell
  • Charles Epstein
  • Roy Bakay
  • Marc Dichter
  • George Vachtsevanos
Part of the Intelligent Systems, Control, and Automation: Science and Engineering book series (ISCA, volume 39)

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.


Epileptic Seizure Temporal Lobe Epilepsy Seizure Onset Epilepsy Surgery Seizure Generation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Science + Business Media B.V. 2009

Authors and Affiliations

  • Brian Litt
    • 1
  • Rosana Esteller
    • 2
    • 3
  • Javier Echauz
    • 4
  • Maryann D'Alessandro
    • 2
    • 5
  • Rachel Shor
    • 2
  • Thomas Henry
    • 6
  • Page Pennell
    • 6
  • Charles Epstein
    • 6
  • Roy Bakay
    • 6
  • Marc Dichter
    • 1
  • George Vachtsevanos
    • 2
  1. 1.Department of Neurology & BioengineeringHospital of the University of Pennsylvania PhiladelphiaUSA
  2. 2.School of Electrical & Computer EngineeringGeorgia Institute of TechnologyAtlantaUSA
  3. 3.Departamento Tecnología IndustrialUniversidad Simón BolívarCaracasVenezuela
  4. 4.Senior Research Scientist and PresidentJE Research, Inc.AlpharettaUSA
  5. 5.Army Research LabsAtlantaUSA
  6. 6.Department of NeurologyEmory University School of MedicineAtlantaUSA

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