High-frequency activity in experimental and clinical epileptic foci

Pathological high-frequency electrographic activity (pHFA, >80Hz) represents one of the major discoveries in epilepsy research over the past few decades. In this review we focus on the high-frequency activity recorded in vivo in chronic models of epilepsy. The presence of HFA particularly of fast ripples (250-600Hz)reflects epileptogenic reorganization of brain tissue, endogenous epileptogenicity and ability to generate spontaneous seizures. The spatial distribution of epileptic HFA can be used to localize epileptic foci. In some regions of brain the localizing value of epileptic HFA is weakened by frequency overlap with physiological HFA. In this situation, only detailed knowledge of the regional physiological activity may provide relevant information which frequencies provide localizing information. In the epileptic hippocampus, the activity from 250Hz to 600Hz frequency band (fast ripples) is always epileptic and can be used as reliable marker of epileptic tissue in all hippocampal subregions. The localizing value of HFA in the identification of the epileptic focus is discussed from an experimental and clinical perspective; as the information provided by HFA can improve presurgical diagnosis and surgical outcome. Finally, research into HFA has contributed to improved understanding and new insights into the cellular and network organization of epileptic foci and the pathophysiology of epilepsy.