TY - JOUR
T1 - Generalized periodic discharges
T2 - Pathophysiology and clinical considerations
AU - van Putten, Michel J.A.M.
AU - Hofmeijer, Jeannette
N1 - This article is part of a Special Issue entitled Status Epilepticus. Open access
PY - 2015/8
Y1 - 2015/8
N2 - Generalized periodic discharges (GPDs) are commonly encountered in metabolic encephalopathy and cerebral hypoxia/ischemia. The clinical significance of this EEG pattern is indistinct, and it is unclear whether treatment with antiepileptic drugs is beneficial. In this study, we discuss potential pathophysiological mechanisms. Based on the literature, supplemented with simulations in a minimal computational model, we conclude that selective synaptic failure or neuronal damage of inhibitory interneurons, leading to disinhibition of excitatory pyramidal cells, presumably plays a critical role. Reversibility probably depends on the potential for functional recovery of these interneurons. Whether antiepileptic drugs are helpful for regaining function is unclear.
AB - Generalized periodic discharges (GPDs) are commonly encountered in metabolic encephalopathy and cerebral hypoxia/ischemia. The clinical significance of this EEG pattern is indistinct, and it is unclear whether treatment with antiepileptic drugs is beneficial. In this study, we discuss potential pathophysiological mechanisms. Based on the literature, supplemented with simulations in a minimal computational model, we conclude that selective synaptic failure or neuronal damage of inhibitory interneurons, leading to disinhibition of excitatory pyramidal cells, presumably plays a critical role. Reversibility probably depends on the potential for functional recovery of these interneurons. Whether antiepileptic drugs are helpful for regaining function is unclear.
U2 - 10.1016/j.yebeh.2015.04.007
DO - 10.1016/j.yebeh.2015.04.007
M3 - Article
SN - 1525-5050
VL - 49
SP - 228
EP - 233
JO - Epilepsy & behavior
JF - Epilepsy & behavior
ER -