Epilepsy - Neurobiology and aetiology

This slide deck provides an overview of the neurobiology and aetiology of epilepsy, exploring how abnormal neuronal activity leads to seizures and how factors such as genetics, structural and metabolic causes, and inflammation contribute to the disorder. It reviews the epileptogenesis, and the mechanisms of blood–brain barrier in seizure development. The deck also highlights how animal and human studies are advancing understanding towards new therapeutic strategies for epilepsy.

This slide deck was developed by Professor Dr. Amy Brooks-Kayal, Department of Neurology, University of California, Davis, School of Medicine; and Professor. Dr. Gretchen Birbeck, Rykenboer Professor of Neurology at the University of Rochester, New York, USA, in collaboration with Cambridge (a division of Prime, Cambridge, UK).

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Index for
slide deck

Introduction

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What is epilepsy?

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What is epilepsy?

Reference:

1.Fisher RS, Acevedo C, Arzimanoglou A, et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia 2014; 55 (4): 475–482.

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Brain activity during the stages of a seizure

References:

1.Ra JS, Li T, YanLi. A novel epileptic seizure prediction method based on synchroextracting transform and 1-dimensional convolutional neural network. Comput Methods Programs Biomed 2023; 240: 107678.

2.Ibrahim AK, Zhuang H, Tognoli E, et al. Epileptic seizure…

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Interictal epileptiform discharges

The slide shows the International Federation of Clinical Neurophysiology criteria for epileptiform discharge, based on identification of ≥4 of the 6 criteria:¹

1.sharp or spiky morphology1 (20–70 milliseconds for spike waves; 70–200 milliseconds for sharp waves²)

2.differ…

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Neurotransmitter pathways involved in seizures

References:

1.González MI, Brooks-Kayal A. Altered GABA(A) receptor expression during epileptogenesis. Neurosci Lett 2011; 497 (3): 218–222.

2.Tipton AE, Russek SJ. Regulation of inhibitory signaling at the receptor and cellular level; advances in our understanding of GAB…

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Seizure classification

The slide shows the classification of seizures according to the International League Against Epilepsy classification.¹ There are three main classes of seizure – focal, unknown, and generalized – within which there are many different types.¹ The state of consciousness shou…

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Brain activity in focal versus generalized seizures

References:

1.Markand ON. Pearls, perils, and pitfalls in the use of the electroencephalogram. Semin Neurol 2003; 23 (1): 7–46.

2.Stafstrom CE, Carmant L. Seizures and epilepsy: an overview for neuroscientists. Cold Spring Harb Perspect Med 2015; 5 (6): a022426.

3.Devinsk…

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Types of generalized seizure

Whilst focal seizures begin in one hemisphere of the brain, generalized seizures originate in neural networks that span both hemispheres.¹ Furthermore, a seizure can start focally and then spread to both sides of the brain.¹

Reference:

1.Stafstrom CE, Carmant L. Seizures …

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Status epilepticus

Long-lasting seizures (30 minutes or longer) are a danger to health and can increase the risk of death; the prompt recognition and treatment of status epilepticus is crucial for a patient’s health.²

References:

1.NHS website. Epilepsy. Available at: https://www.nhs.uk/con…

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Epileptogenesis – how does enduring susceptibility to seizures occur?

Many neurophysiological changes occur within the brain during seizures, a range of interacting changes including some that compensate for others, which together drive epilepsy pathology.¹ The wideness of the range of known epileptogenic mechanisms suggests a complex web o…

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