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Human seizures self-terminate across spatial scales via a critical transition.


ABSTRACT: Why seizures spontaneously terminate remains an unanswered fundamental question of epileptology. Here we present evidence that seizures self-terminate via a discontinuous critical transition or bifurcation. We show that human brain electrical activity at various spatial scales exhibits common dynamical signatures of an impending critical transition--slowing, increased correlation, and flickering--in the approach to seizure termination. In contrast, prolonged seizures (status epilepticus) repeatedly approach, but do not cross, the critical transition. To support these results, we implement a computational model that demonstrates that alternative stable attractors, representing the ictal and postictal states, emulate the observed dynamics. These results suggest that self-terminating seizures end through a common dynamical mechanism. This description constrains the specific biophysical mechanisms underlying seizure termination, suggests a dynamical understanding of status epilepticus, and demonstrates an accessible system for studying critical transitions in nature.

SUBMITTER: Kramer MA 

PROVIDER: S-EPMC3529091 | biostudies-literature | 2012 Dec

REPOSITORIES: biostudies-literature

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Human seizures self-terminate across spatial scales via a critical transition.

Kramer Mark A MA   Truccolo Wilson W   Eden Uri T UT   Lepage Kyle Q KQ   Hochberg Leigh R LR   Eskandar Emad N EN   Madsen Joseph R JR   Lee Jong W JW   Maheshwari Atul A   Halgren Eric E   Chu Catherine J CJ   Cash Sydney S SS  

Proceedings of the National Academy of Sciences of the United States of America 20121204 51


Why seizures spontaneously terminate remains an unanswered fundamental question of epileptology. Here we present evidence that seizures self-terminate via a discontinuous critical transition or bifurcation. We show that human brain electrical activity at various spatial scales exhibits common dynamical signatures of an impending critical transition--slowing, increased correlation, and flickering--in the approach to seizure termination. In contrast, prolonged seizures (status epilepticus) repeate  ...[more]

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