Department of Neurology, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, U.S.A.
Epilepsia. 2013 Sep;54 Suppl 6(0 6):37-9. doi: 10.1111/epi.12273.
The traditional view of seizure activity is one in which there is extreme hypersynchronization. Although what is meant by hypersynchronization is rarely explicitly and fully defined, it can be understood to imply large numbers of neurons firing together essentially simultaneously. In this discussion we explore the possibility that seizures-both self-terminating and sustained in status-are not purely synchronous in time or in space. We investigate the alternative possibility that much seizure activity represents spatiotemporal desynchronization. Furthermore, we discuss the possibility that, in contrast to canonical views of epileptic activity, a high degree of synchronization is a prerequisite for termination of the seizure rather than a marker of early and ongoing seizure activity. These ideas will be discussed with reference to results from our collaborative group based on microelectrode recordings in patients with epilepsy as well as to the many studies done by others in both patients and animal models. Finally, we will explore implications for these hypotheses in the treatment of patients with epilepsy and in status epilepticus.
传统观点认为癫痫发作活动具有极度的超同步性。尽管超同步的含义很少被明确和完全定义，但可以理解为它意味着大量神经元基本上同时一起放电。在本次讨论中，我们探讨了癫痫发作（包括自终止和持续状态）在时间或空间上并非完全同步的可能性。我们研究了另一种可能性，即大部分癫痫发作活动代表时空去同步化。此外，我们还讨论了这样一种可能性，即与癫痫活动的典型观点相反，高度同步是癫痫发作终止的先决条件，而不是早期和持续癫痫发作活动的标志。这些观点将参考我们合作小组基于癫痫患者微电极记录的结果以及其他许多在患者和动物模型中进行的研究来进行讨论。最后，我们将探讨这些假设对癫痫患者治疗和癫痫持续状态的影响。
