Current opinion in neurology
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Curr. Opin. Neurol. · Apr 2012
ReviewFunctional imaging of seizures and epilepsy: evolution from zones to networks.
Epilepsy research has extended from studies at the cellular level to the investigation of interactions of large neuronal populations distant from one another: 'epileptic networks'. This article underlines the concept of epilepsies as network disorders, adding empirical evidence from electroencephalography-combined functional MRI (EEG-fMRI) studies. ⋯ The appreciation of epileptic processes at the network level will foster the development of both anticonvulsive as well as true antiepileptic treatment strategies locally modulating hub regions within the epileptic network architecture as well as entire networks by targeting their characteristic properties such as neurotransmitter or neuronal firing profiles. Treatment should reach beyond seizure control and include the improvement of cognitive function.
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Curr. Opin. Neurol. · Apr 2012
ReviewSudden unexpected death in epilepsy: mechanisms, prevalence, and prevention.
Sudden unexpected death in epilepsy (SUDEP) is a fatal complication of epilepsy with incidence rates of up to nine per 1000 patient-years in candidates for epilepsy surgery. Ongoing collaborative research is aiming to improve assessment of individual SUDEP risk and to develop preventive measures based on pathophysiological considerations. This review focuses on novel findings in humans and animal models related to pathophysiology, risk factors and prevention of SUDEP. ⋯ Novel clinical features may help to define better the individual risk of SUDEP. Potentially therapeutic strategies including pharmacological modulation of respiratory arrest and implantation of cardiac devices could reduce the risk of SUDEP in some individuals. Antiepileptic drugs lower the risk, stressing the importance of successful seizure control for prevention.