Human seizures self-terminate across spatial scales via a critical transition

Proc Natl Acad Sci U S A. 2012 Dec 18;109(51):21116-21. doi: 10.1073/pnas.1210047110. Epub 2012 Dec 4.


Why seizures spontaneously terminate remains an unanswered fundamental question of epileptology. Here we present evidence that seizures self-terminate via a discontinuous critical transition or bifurcation. We show that human brain electrical activity at various spatial scales exhibits common dynamical signatures of an impending critical transition--slowing, increased correlation, and flickering--in the approach to seizure termination. In contrast, prolonged seizures (status epilepticus) repeatedly approach, but do not cross, the critical transition. To support these results, we implement a computational model that demonstrates that alternative stable attractors, representing the ictal and postictal states, emulate the observed dynamics. These results suggest that self-terminating seizures end through a common dynamical mechanism. This description constrains the specific biophysical mechanisms underlying seizure termination, suggests a dynamical understanding of status epilepticus, and demonstrates an accessible system for studying critical transitions in nature.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biophysics / methods
  • Brain / physiopathology*
  • Brain Mapping / methods
  • Computer Simulation
  • Electrocardiography / methods
  • Electrodes
  • Electroencephalography / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Models, Biological
  • Seizures / physiopathology*
  • Status Epilepticus / physiopathology*