Subcortical epilepsy?
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Abstract
In the past, the cortex has for the most part been considered to be the site of seizure origin in the different forms of epilepsy. Findings from histopathologic, electrophysiologic, and brain imaging studies now provide ample evidence demonstrating that like normal cerebral function, epileptic seizures involve widespread network interactions between cortical and subcortical structures. These studies show that different forms of generalized and focal epileptiform discharges and seizures engage various subcortical structures in varying ways. This interaction has been the subject of many reviews and is not the focus of the current work. The aim of this review is to examine the evidence suggesting the possibility for some of the subcortical structures to initiate seizures independently and the clinical implications of this.
GLOSSARY
- DBS=
- deep brain stimulation;
- GSW=
- generalized spike-wave discharges;
- VNS=
- vagus nerve stimulation
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Supplemental data at www.neurology.org
- Received July 24, 2012.
- Accepted in final form February 1, 2013.
- © 2013 American Academy of Neurology
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Disputes & Debates: Rapid online correspondence
- Basal ganglia in epileptic seizures
- Ivan Rektor, Professor, Masaryk University, CEITECm Centre of Neuroscience, Brno, Czech Republicirektor@med.muni.cz
Submitted February 24, 2014 - Cerebellar seizures: an alternate explanation
- Joe Verghese, Physician, Albert Einstein College of Medicinejoe.verghese@einstein.yu.edu
- Isabelle Rapin, Bronx, NY; Joe Verghese, Bronx, NY
Submitted July 15, 2013 - Subcortical Epilepsy-the role of Stereo-EEG
- Nitin K. Sethi, Assistant Professor of Neurology, New York-Presbyterian Hospital Weill Cornell Medical Center 525 East 68th Street, New York, NYsethinitinmd@hotmail.com
- Nitin K Sethi, New York, NY
Submitted May 24, 2013 - Response from the authors
- Radwa A B Badawy, Doctor, Department of Medicine, The University of Melbournebadawyr@unimelb.edu.au
- Radwa Badawy, Melbourne, Australia
Submitted May 24, 2013
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