The potential role of spreading depolarization in epilepsy seizure initiation

Title: Spreading Depolarization Facilitates the Transition of Neuronal Burst Firing from Interictal to Ictal State

Journal: Neuroscience (2020) 441:176-183

Link: https://doi.org/10.1016/j.neuroscience.2020.05.029

Comments:

As a clinical physiotherapist, I have experienced several patients who developed epilepsy after a stroke. For these cases, in addition to standard rehabilitation interventions, lifestyle guidance on how to control occurrence of epileptic seizures and how to ensure physical safety during seizures should be provided. However, at present, there is a limit to teaching methods for controlling the occurrence of epilepsy seizures due to a lack of understanding of the pathophysiology of epilepsy after stroke.

This is a paper showing that spreading depolarization (SD) can play a major role in causing epileptic seizures. SD is a phenomenon in which local brain activity is attenuated when an electrical, mechanical, or chemical stimulus is applied to the cerebral cortex, and the attenuation propagates concentrically to the entire hemisphere. Since the electrophysiological event modulates not only brain activity but also cerebrovascular hemodynamics, it is thought to be deeply involved in the development of stroke and the progression of brain tissue destruction after stroke. In addition, this paper proposes that SD can also be involved in the development of epilepsy. A better understanding of SD is expected to refine not only the control of epilepsy after stroke but also the prevention and treatment of stroke.