Abstract
In this case study, we present evidence of resetting of brain dynamics following convulsive status epilepticus (SE) that was treated successfully with antiepileptic medications (AEDs). The measure of effective inflow (EI), a novel measure of network connectivity, was applied to the continuously recorded multichannel intracranial stereoelectroencephalographic (SEEG) signals before, during and after SE. Results from this analysis indicate trends of progressive reduction of EI over hours up to the onset of SE, mainly at sites of the epileptogenic focus with reversal of those trends upon successful treatment of SE by AEDs. The proposed analytical framework is promising for elucidation of the pathology of neuronal network dynamics that could lead to SE, evaluation of the efficacy of SE treatment strategies, as well as the development of biomarkers for susceptibility to SE.
Highlights
Status epilepticus (SE) is a life-threatening neurological and medical emergency seen commonly at tertiary care epilepsy centers [1, 2]
Both preclinical and clinical studies have demonstrated that seizures that are provoked by infection or induced by stimulants can transition to SE if the initial insult is removed, even in subjects without a known history of epilepsy [7,8,9,10,11]
We have shown that generalized partial direct coherence (GPDC) outperforms many traditional measures of directed interactions in the frequency domain [e.g., partial coherence, directed coherence, partial directed coherence (PDC), normalized PDC, directed transfer function (DTF), normalized
Summary
Status epilepticus (SE) is a life-threatening neurological and medical emergency seen commonly at tertiary care epilepsy centers [1, 2]. Unlike seizures that can self-terminate within minutes, the neural condition of SE can self-perpetuate and self-sustain over hours to days Both preclinical and clinical studies have demonstrated that seizures that are provoked by infection or induced by stimulants can transition to SE if the initial insult is removed, even in subjects without a known history of epilepsy [7,8,9,10,11]. In convulsive SE, the recorded electroencephalographic (EEG) activity of the brain progresses through five visually distinguishable sequential stages that are characterized well in preclinical studies and have been reported in patients [12, 13] All these studies suggest that SE may not be a continuum of multiple seizures but rather a distinct entity with its own underlying mechanisms
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