Visualization of epileptogenic phenomena using cross-correlation analysis: localization of epileptic foci and propagation of epileptiform discharges.

The main objectives of the preoperative evaluation of a patient with medically intractable epileptic seizures are localization of the foci and propagation of the epileptiform discharges. Electrocorticographic (ECoG) data of intractable focal epilepsy were analyzed using an AR model, wavelet analysis, and cross-correlation analysis. In order to derive the time-shifts, the cross correlations of the epileptiform discharges were calculated between electrodes for every unit of time. Further analyses were made by means of a set of contour maps of the time-shifts and sequential two- and three-dimensional visualizations of the time-shift maps in order to localize the epileptic foci and study their propagation process. Two types of foci and propagation were revealed in the results. In the first type, epileptiform discharges were generated at localized focal sites and spread quickly to other sites. In the second type, the foci of epileptiform discharges, which appeared soon after the former bursts, were localized at more than one site, and the discharges tended to spread more slowly. The findings suggest that epileptic phenomena can be caused by at least two kinds of mechanisms in one patient: in the former, the propagation might be mediated through synaptic projections, while in the latter, the extracellular diffusion of an excitatory factor might play an important role. In addition, our newly developed visualization technique for the localization of epileptic foci and the propagation of epileptiform discharges should prove useful in the study of epileptogenesis etiology.