A theoretical approach to the contribution and significance of physiological antiepileptic systems in the clinical manifestations of epileptic symptoms.

The onset an of epileptic seizure is the most striking event in the pathophysiology of epilepsy from the clinical aspect. Present knowledge concerning the pathomechanism of the disease does not explain why, in spite of a permanent epileptic dysfunction, the occurrence of clinical seizures is relatively rare even in severe epilepsies. According to my hypothesis, the clinical picture is determined by the balance of two systems of opposite nature (i.e. epileptogenic and antiepileptic). Regarding these systems, research has focused exclusively on the former. A short survey is given here of everyday clinical and EEG experiences which cannot be explained on the basis of epileptic dysfunction and may therefore be considered as indirect evidence of the existence of a physiological antiepileptic system. The hypothesis may also help to explain some special events like occasional epileptic symptoms, 'positive' electroencephalography without clinical signs and the influence of provoking factors. It further clearly shows the place of nonpharmacological (psychological) treatments for epilepsy, stressing the importance of an holistic attitude.