Ictal signatures of subcortical brain structures in focal epilepsy


  • Thalamic involvement during seizures is common in discrete seizure types; therefore, degree of thalamic epileptogenicity (TE) may constitute a potential marker of epileptogenic network (EN) and post-surgical prognosis.

Why this matters

  • Subcortical-cortical connectivity (SCC) may be altered in different epilepsy types, and deep brain stimulation targeting subcortical regions such as the thalamus can be a treatment option for some patients; but SCC mechanisms during seizures is largely unknown.

  • The occurrence of TE in discrete epilepsy types constitutes a potential EN marker, helping to inform post-surgical outcomes in patients and thus tailor their care, and calls into question the current vision of ‘focal’ epilepsy, instead alluding to an extended network based on SCC.