​The curse of propagation: can we tell where spikes and seizures start?

​Abstract: The electrophysiological hallmarks of epilepsy, epileptic seizures and interictal spikes, play a major role in defining the type of epilepsy and the brain localization of the source of epileptic discharges. The localization information is crucial when considering surgical treatment of medically refractory epilepsy. An important but often overlooked issue clouds the interpretation of the localization of the origin of epileptic discharges: these discharges propagate through the brain and the observed phenomena may reflect the result of propagation rather than the source of discharges, in particular because the two types of discharges look very similar. We will discuss how combining EEG with imaging methods, fMRI and tractography in particular, can help find the actual origin of epileptic discharges or at least inform us on the likelihood that a discharge is or is not the result of propagation.

​Jean Gotman

​Jean Gotman is Professor Emeritus at the Montreal Neurological Institute, McGill University. He received an engineering degree from the University of Paris, a Master’s degree in Computer Science from Dartmouth College, and a PhD in Neuroscience from McGill University. He pioneered the automatic detection of spikes and seizures during long-term EEG monitoring of patients with epilepsy and made his methods widely available through Stellate, a company he created in 1986 and the first McGill spin-off, which developed and sold all over the world novel equipment for EEG, epilepsy monitoring and polysomnography. He published over 380 peer-reviewed papers, and mentored over 100 graduate students and fellows. His research interests include analysis of the EEG, mechanisms of epileptogenesis, seizure generation and spread in humans, High Frequency Oscillations and functional imaging in the diagnosis and study of epilepsy.

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