Collapse of interictal suppressive networks permits seizure spread.

How do brain networks limit seizure activity? In the Interictal Suppression Hypothesis, we recently postulated that high inward connectivity to seizure onset zones (SOZs) from non-involved zones (NIZs) is a sign of broader network suppression. If broad networks appear to be responsible for interictal SOZ suppression, what changes during seizure initiation, spread, and termination? For patients with drug-resistant epilepsy, intracranial monitoring offers a view into the electrographic networks which organize around and in response to the SOZ. In this manuscript, we investigate network dynamics in the peri-ictal periods to assess possible mechanisms of seizure suppression and the consequences of this suppression being overwhelmed.

Deep learning on brief interictal intracranial recordings can accurately characterize seizure onset zones.

Objective: Epilepsy is a debilitating disorder affecting more than 50 million people worldwide, and one third of patients continue to have seizures despite maximal medical management. If patients' seizures localize to a discrete brain region, termed a seizure onset zone, resection may be curative. Localization is often confirmed with stereotactic electroencephalography; however, this may require patients to stay in the hospital for weeks to capture spontaneous seizures.