Propagation of human complex-partial seizures: a correlation analysis

Abstract

Inter- and intrahemispheric propagation of ictal discharges was analysed in 7 epileptic patients having chronic intracranial electrodes. Five had temporal foci and two had frontal mesial foci. Correlation analysis of seizure discharge was used to detect the emergence of linear relationships between different structures both intra- and interhemispherically. This analysis included mesial and lateral temporal sites, cingulate gyri, anterior ventral and dorsomedial thalamic nuclei during the discharges of 13 ictal episodes. Correlation between temporal mesial structures was found to be low throughout seizure onset. Propagation of paroxysmal activity through the anterior ventral thalamic nuclei and cingulate gyri was observed in all cases with temporal or frontal mesial focus. Propagation of the discharge from the temporal lateral cortex to the contralateral homologue area was observed with a short delay during 4 complex-partial seizures originating in the temporal lobe. These results show that, even though the commissural pathways may have a role in propagation, it is a relatively unimportant one and they suggest that ictal activity during mesial temporal seizures may spread preferentially through the thalamic nuclei and cortical structures.