Challenges of seizure semiology in frontal lobe epilepsy – A. McGonigal MD, PhD
Aileen McGonigal MD, PhD (Aix Marseille Univ, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France & APHM, Timone Hospital, Clinical Neurophysiology, Marseille, France)
Seizure semiology represents the dynamic clinical expression of epileptic seizures and is a key data source providing clues to cerebral organization. It is produced through interactions between electrical seizure discharge and physiological and pathological brain networks. Semiology can be described in spatial and temporal terms; its expression, which may be more or less complex, depends upon both spatial (anatomical localization) and temporal (e.g. discharge frequency, synchrony) characteristics of cerebral electrical activity. A paradox exists with regards to utility of semiological data, essentially due to incomplete knowledge of how cerebral network changes produce clinical patterns. In addition, methodological challenges include observer bias, difficulties in achieving optimal categorisation of signs or clinical patterns and in defining nomenclature. Intracerebral electroencephalography (EEG) studies of electroclinical correlations using stereoelectroencephalography (SEEG), including quantified signal analysis, have helped elucidate several semiological patterns. Future research could help improve pattern recognition of complex semiological expression associated with specific seizure types, possibly incorporating deep learning methods in a multiscale, multimodal modelization framework.
Date : 3 novembre 2020, 14h-15h30
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