Created by Nathan Evans
https://doi.org/10.1016/j.brs.2016.10.003
Deep brain stimulation
Less synchronised just before termination
https://www.sciencedirect.com/science/article/pii/S1059131115001983?via%3Dihub
More synchronised as seizure progresses
podcast
Mechanisms of Seizure Termination.wav
subcortical kill switch - every region stops at once - primarily the thalamas / amigcila
nice review -> "cortical focus theory"
https://pubmed.ncbi.nlm.nih.gov/24919973/
https://www.sciencedirect.com/science/article/pii/S0969996122000365?via%3Dihub
https://onlinelibrary.wiley.com/doi/full/10.1111/epi.17171
entropy https://www.nature.com/articles/nrn2787
https://pmc.ncbi.nlm.nih.gov/articles/PMC8448953/
https://link.springer.com/article/10.1007/s40263-023-01060-1
https://link.springer.com/article/10.1007/s10072-021-05468-9
https://www.tandfonline.com/doi/abs/10.1080/14737175.2022.2105207
https://www.sciencedirect.com/science/article/pii/S152586102300405X
https://link.springer.com/article/10.1007/s11910-011-0207-x
Review of mechanisms at different scales
https://onlinelibrary.wiley.com/doi/full/10.1111/j.1528-1167.2008.01669.x
https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(21)00300-8/fulltext https://www.sciencedirect.com/science/article/pii/S2319417021001104 https://www.sciencedirect.com/science/article/pii/S1094715922012223 https://ins-amu.fr/physionet Three neuromodulation therapies have been appropriately tested and approved in refractory focal epilepsies: vagus nerve stimulation (VNS), deep brain stimulation of the anterior nucleus of the thal...
Fig 3 https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2012.00281/full
Examples of mechanisms
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0114316
https://academic.oup.com/brain/article-abstract/137/8/2210/2847958
https://journals.plos.org/ploscompbiol/article?id=10.1371/journal.pcbi.1003787
Dynamics of convulsive seizure termination and postictal generalized EEG suppressionhttps://academic.oup.com/brain/article/140/3/655/2880232 “Postictal generalized EEG suppression is a separate brain state and that seizure termination is a plastic and autonomous process, reflected in increased duration of interclonic intervals that determine the duration of postictal generalized EEG suppression.”
Quantifying seizure termination patterns reveals limited pathways to seizure endhttps://www.sciencedirect.com/science/article/pii/S0969996122000365 “Based on this spatiotemporal classification scheme, we suggest that there are a limited number of seizure termination patterns and dynamics. If this bears out, it would imply that the number of mechanisms underlying seizure termination is also constrained. Seizures with different termination patterns exhibit different dynamics even before their start. This may provide useful clues about how seizures may be managed, which in turn may lead to more targeted modes of therapy for seizure control.”
On the nature of seizure dynamicshttps://academic.oup.com/brain/article/137/8/2210/2847958 “For the predominant seizure class we developed a generic model called Epileptor.”
Human seizures self-terminate across spatial scalesvia a critical transitionhttps://www.pnas.org/doi/epdf/10.1073/pnas.1210047110 “we implement a computational model that demonstrates that alternative stable attractors, representing the ictal and postictal states, emulate the observed dynamics. These results suggest that self-terminating seizures end through a common dynamical mechanism. This description constrains the specific biophysical mechanisms underlying seizure termination, suggests a dynamical understanding of status epilepticus, and demonstrates an accessible system for studying critical transitions in nature”
The critical dynamics of hippocampal seizureshttps://www.nature.com/articles/s41467-024-50504-9 “ Leveraging pharmacological control over neural excitability, we showed that the boundary between physiological excitability and seizures can be inferred from dynamical signatures passively recorded or actively probed in hippocampal circuits.”
saggio william stacy and victor jirsa https://pmc.ncbi.nlm.nih.gov/articles/PMC7375810/
ion imbalance - extracellular potassium
feed-forward inhibition - stopping further propagation - 2012 scheven
metabolic exhaustion theory - runs out of oxygen/ATP
spreading depression
ictal spect imaging
astrocites and microglia -
"recovery of neurons"
Ketamine:
Putaminal GABAergic pathways
https://link.springer.com/article/10.1007/s40120-023-00515-3 Benzodiazepines are the cornerstone of treatment for seizure clusters. However, prolonged seizures can disrupt the normal expression of inhibitory and excitatory receptors at the neuronal cell membrane, resulting in greater cellular excitation. Internalization of the γ-aminobutyric acid A receptor at the level of the cellular membrane contributes to the attenuated antiseizure effect despite benzodiazepine administration during prolonged seizures or when rescue treatment is delayed.During seizures, γ-aminobutyric acid A (GABAA) receptors are internalized, and N-methyl-d-aspartic acid (NMDA) receptors accumulate in the postsynaptic membrane, resulting in loss of inhibition and increased excitation. These changes favor self-sustaining seizures and resistance to benzodiazepines
https://www.sciencedirect.com/science/article/pii/S1059131118308173?via%3Dihub
https://onlinelibrary.wiley.com/doi/10.1046/j.1528-1157.2002.45201.x
cycles in epilepsy review
Gabrielle & Mariella's circadian rythms
Mariella's paper - seizure duration linked to ultradian-circadian band power cycleshttps://arxiv.org/pdf/2504.17888
Gabrielle's paper https://academic.oup.com/braincomms/article/4/4/fcac173/6632712#366641283
seizures occurring during sleep are longer?https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1528-1157.1997.tb01077.x seizures occurring during sleep are not longer? (or at least, they aren't longer in particular sleep stages?)https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(21)00214-5/fulltextthis agrees with ^https://www.neurology.org/doi/full/10.1212/WNL.56.11.1453