2000
Year 20
Prof. Timothy A. Pedley
Henry & Lucy Moses Professor of Neurology
Columbia University, New York, USA
THEME: EPILEPSY AT THE MILLENNIUM: NEW PERSPECTIVES FROM INTEGRATION OF NEUROBIOLOGICAL AND CLINICAL DATA.
Seizure phenomenology is complex and diverse. On the one hand, the physiological mechanisms affecting
membrane depolarisation and repolarisation, result in neuronal deregulation. On the other, a network defect
with aberrant neuronal integration and an abnormal synchronization of neuronal populations, results in the
propagation of epileptic discharge within the neuronal pathways.
In assessing patients for epilepsy surgery, one must distinguish between the irritative zone, the ictal onset zone, the epileptogenic zone and the epileptogenic lesion. Intracerebral EEG recordings demonstrate that interictal spikes are more widespread than detected by scalp recording. This has been confirmed by PET studies. The pathological changes in the brain in epilepsy are best seen in the hippocampal sclerosis of temporal lobe epilepsy. Genetic predisposition and environmental factors interact to manifest a seizure attack. There is increasing evidence of a hereditary component, variable in degree, in all forms of epilepsy, whether it is localised or generalised, idiopathic or acquired.
In assessing patients for epilepsy surgery, one must distinguish between the irritative zone, the ictal onset zone, the epileptogenic zone and the epileptogenic lesion. Intracerebral EEG recordings demonstrate that interictal spikes are more widespread than detected by scalp recording. This has been confirmed by PET studies. The pathological changes in the brain in epilepsy are best seen in the hippocampal sclerosis of temporal lobe epilepsy. Genetic predisposition and environmental factors interact to manifest a seizure attack. There is increasing evidence of a hereditary component, variable in degree, in all forms of epilepsy, whether it is localised or generalised, idiopathic or acquired.
