Mechanisms of epileptogenesis in photosensitive epilepsy implied by the effects of moving patterns.

The triggering of epileptiform EEG discharges by pattern is thought to depend on the intensity of excitation within the visual cortex. The present study investigates the role of the synchronisation of neuronal activity by the stimulus. In 10 pattern-sensitive subjects the effects of the following patterns have been compared: (1) static gratings, (2) gratings oscillating in a direction orthogonal to the lines (which should synchronise activity in direction-sensitive cortical units), and (3) gratings drifting at the same angular velocity (which should produce little or no synchronisation, because the contours enter and leave the overlapping receptive fields of individual neurones asynchronously). The oscillating gratings were most, and the drifting least, epileptogenic. In 2 further subjects oscillating and phase-reversing patterns were more epileptogenic than drifting gratings. Although open to alternative explanations, the findings conform with predictions from the hypothesis that synchronisation of individual cortical neurones by the stimulus contributes to epileptogenesis in photosensitive subjects.