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Generalized periodic discharges: Pathophysiology and clinical considerations
Michel J A M van Putten1, Jeannette Hofmeijer2
1Department of Clinical Neurophysiology, MIRA, Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands; Dept of Neurology and Clinical Neurophysiology, Medisch Spectrum Twente, Enschede, The Netherlands.
Epilepsy & Behavior : E&B
|May 7, 2015
Summary
Generalized periodic discharges (GPDs) on EEG may stem from inhibitory interneuron damage, causing disinhibition. The benefit of antiepileptic drugs for GPDs in metabolic encephalopathy or hypoxia remains uncertain.
Area of Science:
- Neuroscience
- Epileptology
- Computational modeling
Background:
- Generalized periodic discharges (GPDs) are observed in metabolic encephalopathy and cerebral hypoxia/ischemia.
- The clinical significance and optimal treatment for GPDs are not well-established.
Purpose of the Study:
- To explore the pathophysiological mechanisms underlying GPDs.
- To evaluate the potential role of inhibitory interneuron dysfunction in GPD generation.
- To discuss the implications for antiepileptic drug treatment.
Main Methods:
- Literature review on GPDs.
- Simulations using a minimal computational model.
Main Results:
- Selective synaptic failure or damage to inhibitory interneurons likely causes disinhibition of pyramidal cells, contributing to GPDs.
- The potential for functional recovery of interneurons may influence the reversibility of GPDs.
Conclusions:
- Inhibitory interneuron dysfunction is a probable key mechanism in GPDs.
- The efficacy of antiepileptic drugs in restoring function associated with GPDs requires further investigation.
Keywords:
Feedforward inhibitionGeneralized periodic dischargesMeanfield modelStatus epilepticusSynaptic failureMore Related Videos
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