A CLINICAL RESEARCH PROGRAM FOR THE PARTIAL EPILEPSIES

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In persons with partial epilepsy seeking relief from seizures by surgical treatment arrays of stereotactically implanted intracerebral electrodes are placed in possible seizure foci and monitored by EEG pattern and extracellular action potentials for several weeks. The temporal-spatial relationship of the onset and development of the ictal EEG during simultaneous registration of the behavioral seizure has proven to be the most reliable evidence for the primary focus, obtained in approximately three-fourths of patients. Computer methods are being developed to quantify interictal abnormalities as a similar index. We hope to develop surface EEG correlates equivalent to detection of depth spiking, establishing areas of speech dominance and memory competence. At the cellular level studies are being conducted on the basic mechanisms of epileptogenesis of neurons in the limbic system, the effects of carbamazepine on these neurons, and ultrastructural and Golgi staining of neurons in excised specimens. Neurophysiological experiments correlate hippocampal neuronal responsiveness to tests of memory, spatial cognitive function, movement, behavioral sequencing, visual receptive fields and during sleep stages. Clinical neuropsychological studies examine the relationship of psychological manifestations of temporal lobe epilepsy to epileptiform discharges and clinical-pathological factors.