Resolution revolution: epilepsy dynamics at the microscale

- Normal and pathological brain states have been proposed to coexist.
- Variability in the oscillatory dynamics within seizure foci has been shown.
- Recurrent epileptiform events involve heterogeneous cell populations.
- Increased resolution in epilepsy dynamics may lead to more focused therapy.

Our understanding of the neuronal mechanisms behind epilepsy dynamics has recently advanced due to the application of novel technologies, monitoring hundreds of neurons with single cell resolution. These developments have provided new theories on the relationship between physiological and pathological states, as well as common motifs for the propagation of paroxysmal activity. Although traditional electroencephalogram (EEG) recordings continue to describe normal network oscillations and abnormal epileptic events within and outside of the seizure focus, analysis of epilepsy dynamics at the microscale has found variability in the composition of macroscopically repetitive epileptiform events. These novel results point to heterogeneity in the underlying dynamics of the disorder, highlighting both the need and potential for more specific and targeted therapies.