Interictal spikes in focal epileptogenesis

Prog Neurobiol. 2001 Apr;63(5):541-67. doi: 10.1016/s0301-0082(00)00026-5.

Abstract

Interictal electroencephalography (EEG) potentials in focal epilepsies are sustained by synchronous paroxysmal membrane depolarization generated by assemblies of hyperexcitable neurons. It is currently believed that interictal spiking sets a condition that preludes to the onset of an ictal discharge. Such an assumption is based on little experimental evidence. Human pre-surgical studies and recordings in chronic and acute models of focal epilepsy showed that: (i) interictal spikes (IS) and ictal discharges are generated by different populations of neuron through different cellular and network mechanisms; (ii) the cortical region that generates IS (irritative area) does not coincide with the ictal-onset area; (iii) IS frequency does not increase before a seizure and is enhanced just after an ictal event; (iv) spike suppression is found to herald ictal discharges; and (v) enhancement of interictal spiking suppresses ictal events. Several experimental evidences indicate that the highly synchronous cellular discharge associated with an IS is generated by a multitude of mechanisms involving synaptic and non-synaptic communication between neurons. The synchronized neuronal discharge associated with a single IS induces and is followed by a profound and prolonged refractory period sustained by inhibitory potentials and by activity-dependent changes in the ionic composition of the extracellular space. Post-spike depression may be responsible for pacing interictal spiking periodicity commonly observed in both animal models and human focal epilepsies. It is proposed that the strong after-inhibition produced by IS protects against the occurrence of ictal discharges by maintaining a low level of excitation in a general condition of hyperexcitability determined by the primary epileptogenic dysfunction.

Publication types

  • Review

MeSH terms

  • Action Potentials*
  • Calcium Channels / metabolism
  • Cerebral Cortex / metabolism
  • Cerebral Cortex / physiopathology
  • Electroencephalography*
  • Epilepsies, Partial / diagnosis*
  • Epilepsies, Partial / metabolism
  • Epilepsies, Partial / physiopathology*
  • Humans
  • Neural Inhibition
  • Periodicity
  • Receptors, Glutamate / metabolism
  • Sodium Channels / metabolism
  • Synaptic Transmission

Substances

  • Calcium Channels
  • Receptors, Glutamate
  • Sodium Channels