CELLULAR MECHANISMS OF EPILEPSY - A STATUS-REPORT
CELLULAR MECHANISMS OF EPILEPSY - A STATUS-REPORT
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DOI：
10.1126/science.3037700
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发表时间：
1987-07-10
期刊：
影响因子：
56.9
通讯作者：
AYALA, GF
中科院分区：
文献类型：
--
作者：
DICHTER, MA;AYALA, GF
目前，在细胞和突触功能的当代概念的背景下，可以理解局灶性癫痫背后的细胞现象。发作间期放电似乎是由于突触事件和固有电流的组合所致，任何给定神经元中的确切比例可能根据癫痫放电涉及的解剖和功能基质以及给定模型中使用的致癫痫剂而变化。向癫痫发作的转变似乎是由于兴奋性影响的同时增加和抑制过程的减少所致——两者都与频率依赖性神经元事件有关。已经提出了多种具体假设来解释癫痫样活动期间发生的兴奋性增加。尽管所提出的每种机制都可能对癫痫过程做出重大贡献，但没有任何单一假设提供了可以理解各种局灶性癫痫的排他性统一框架。癫痫活动在整个大脑中的传播、原发性全身性癫痫的发展、特定解剖位置中“门控”机制的存在，以及从局灶性癫痫的简单模型中推断出的假设来解释更复杂的人类癫痫形式，所有这些都尚未完全了解。
The cellular phenomena underlying focal epilepsy are currently understood in the context of contemporary concepts of cellular and synaptic function. Interictal discharges appear to be due to a combination of synaptic events and intrinsic currents, the exact proportion of which in any given neuron may vary according to the anatomic and functional substrate involved in the epileptic discharge and the epileptogenic agent used in a given model. The transition to seizure appears to be due to simultaneous increments in excitatory influences and decrements in inhibitory processes—both related to frequency-dependent neuronal events. A variety of specific hypotheses have been proposed to account for the increased excitability that occurs during epileptiform activity. Although each of the proposed mechanisms is likely to contribute significantly to the epileptic process, no single hypothesis provides an exclusive unifying framework within which all kinds of focal epilepsy can be understood. The spread of epileptic activity throughout the brain, the development of primary generalized epilepsy, the existence of "gating" mechanisms in specific anatomic locations, and the extrapolation of hypotheses derived from simple models of focal epilepsy to explain more complex forms of human epilepsy, all are not yet fully understood.