Chance and risk in epilepsy.

Baud, Maxime O.; Proix, Timothée; Rao, Vikram R; Schindler, Kaspar (2020). Chance and risk in epilepsy. Current opinion in neurology, 33(2), pp. 163-172. Lippincott Williams & Wilkins 10.1097/WCO.0000000000000798

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PURPOSE OF REVIEW Epilepsy is a dynamical disorder of the brain characterized by sudden, seemingly unpredictable transitions to the ictal state. When and how these transitions occur remain unresolved questions in neurology. RECENT FINDINGS Modelling work based on dynamical systems theory proposed that a slow control parameter is necessary to explain the transition between interictal and ictal states. Recently, converging evidence from chronic EEG datasets unravelled the existence of cycles of epileptic brain activity at multiple timescales - circadian, multidien (over multiple days) and circannual - which could reflect cyclical changes in a slow control parameter. This temporal structure of epilepsy has theoretical implications and argues against the conception of seizures as completely random events. The practical significance of cycles in epilepsy is highlighted by their predictive value in computational models for seizure forecasting. SUMMARY The canonical randomness of seizures is being reconsidered in light of cycles of brain activity discovered through chronic EEG. This paradigm shift motivates development of next-generation devices to track more closely fluctuations in epileptic brain activity that determine time-varying seizure risk.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Baud, Maxime and Schindler, Kaspar Anton

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1350-7540

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Chantal Kottler

Date Deposited:

07 Jul 2020 14:51

Last Modified:

27 Jul 2020 19:01

Publisher DOI:

10.1097/WCO.0000000000000798

PubMed ID:

32049738

BORIS DOI:

10.7892/boris.145012

URI:

https://boris.unibe.ch/id/eprint/145012

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