Spikes and Seizures: Step Relatives or Siblings

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• Spikes and Seizures Step Relatives or Siblings?
• Fourth International Seizure Prediction Workshop
• Kansas City, June 2009

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Spikes Seziures Step-relatives Siblings?

• Epilepsia. 2001 Do interictal discharges promote
  or control seizures? Experimental evidence from
  an in vitro model of epileptiform discharge.
  Avoli M.
• Prog Neurobiol. 2001 63541-67. Interictal spikes
  in focal epileptogenesis. de Curtis M, Avanzini G
• Ann Neurol. 200353382-9. Epileptiform ictal
  discharges are prevented by periodic interictal
  spiking in the olfactory cortex. Librizzi L, de
  Curtis M.
• Ann Neurol. 198824591-8.The relationship
  between interictal and ictal paroxysms in an in
  vitro. Rev Neurol (Paris)1999155468-71.
• Interictal-ictal interactions and limbic seizure
  generation. Avoli M, Barbarosie Model of focal
  hippocampal epilepsy. Jensen MS, Yaari Y.

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Spikes Seizures Step-relatives Siblings?

• Focus theory
• System is linear
• System is deterministic
• In-vitro models capture the all key features of
  intact spontaneously epileptic brain
• Human recordings have important limitations

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Spikes and Seizures Step relatives or Sibling?

• Hume's Causality
• Precedence X precedes Y in time
• Contiguity X and Y are contiguous in space and
  time
• Constant Conjunction X and Y always co-occur (or
  not occur).
• - Mixing is a property of systems with sensitive
  dependence on initial conditions which dictates
  that one phenomenon may depend sensitively on
  another phenomenon, yet be statistically
  independent of it (D. Ruelle).
• Probabilistic Causality
• Changes in conceptualization and the equivalent
  of DNA test is needed to understand both
  phenomena
• We dont have a good grasp of seizure and
  epilepsy dynamics yet make absolute
  distinctions
• -

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• The roots of the spike-seizure dichotomy are
  shallow yet have spread like weeds and are
  drought and fire resistant .
• Its logical and evidence-based underpinnings are
  feeble

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ECoG 2 min after bolus of alfentanil activation
of amygdala/hippocampal spikes and suppression of
temporal neocortical spikes
ECoG 10 min later return to pre-activation
baseline of amygdala/hippocampal spikes and
reappearance of independent temporal neocortical
spikes
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• Abnormal brain activity discernible behavioral
  correlates Ictal, otherwise interictal

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• The spike-seizure dichotomy is the hybridized
  construct of the ictiocentric (focus) theory
  and the notion that neural networks processes are
  linear on a deterministic background.

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Spikes Seizures Step-relatives or Siblings?

• The dichotomy (spikes and seizures are
  unrelated) is an inevitable and regrettable
  collorary of the ictiocentric (focus) theory
  (a phrenology remnant) and of the stubborn
  adherence to the belief that linear laws govern
  the behavior pathologic neuronal networks
• The dichotomy (spikes an seizures are unrelated
  is the inbred love child of the ictiocentric
  (focus) theory and of the belief that linear
  laws govern the behavior of normal or pathologic
  neuronal networks borne out of the mating
  between nu

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