PDF(Pubmed)
Abstract：
The propagation of epileptiform events is a highly interesting phenomenon from the pathophysiological point of view, as it involves several mechanisms of recruitment of neural networks. Extensive in vivo and in vitro research has been performed, suggesting that multiple networks as well as cellular candidate mechanisms govern this process, including the co-existence of wave propagation, coupled oscillator dynamics, and more. The clinical importance of seizure propagation stems mainly from the fact that the epileptic manifestations cannot be attributed solely to the activity in the seizure focus itself, but rather to the propagation of epileptic activity to other brain structures. Propagation, especially when causing secondary generalizations, poses a risk to patients due to recurrent falls, traumatic injuries, and poor neurological outcome. Anti-seizure medications (ASMs) affect propagation in diverse ways and with different potencies. Importantly, for drug-resistant patients, targeting seizure propagation may improve the quality of life even without a major reduction in simple focal events. Motivated by the extensive impact of this phenomenon, we sought to review the literature regarding the propagation of epileptic activity and specifically the effect of commonly used ASMs on it. Based on this body of knowledge, we propose a novel classification of ASMs into three main categories: major, minor, and intermediate efficacy in reducing the propagation of epileptiform activity.
摘要：
从病理生理学的角度来看，癫痫样事件的传播是一个非常有趣的现象，因为它涉及神经网络的几种募集机制。已经进行了广泛的体内和体外研究，这表明多个网络以及细胞候选机制控制着这个过程，包括波传播的共存，耦合振荡器动力学，还有更多.癫痫发作传播的临床重要性主要源于以下事实：癫痫发作的表现不能仅归因于癫痫发作焦点本身的活动，而是将癫痫活动传播到其他大脑结构。传播,尤其是当引起二次概括时，由于反复跌倒会给患者带来风险，外伤,和不良的神经系统结果。抗癫痫药物（ASM）以不同的方式和不同的效力影响传播。重要的是,对于耐药患者，靶向性癫痫发作传播可以改善生活质量,即使简单局灶性事件没有大幅减少.受这一现象的广泛影响,我们试图回顾有关癫痫活动传播的文献，特别是常用ASM对其的影响。基于这些知识，我们提出了一种新的ASM分类，分为三大类：主要，未成年人,和减少癫痫样活动传播的中等功效。
