Abstract Details

Title Role of Cerebellar Disinhibition in the Development of Seizures

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P5 - Poster Session 5 (8:00 AM-9:00 AM)

Poster/Presentation
Number 12-004

Objective We hypothesize that loss of inhibition from cerebellum can lead to cortical seizures.

Background The traditional model for the development of seizures purports that increased electrical activity originating from the neurons of the cerebral cortex is the source of unprovoked seizures. However, studies have shown that decrease in inhibition result in a shift of cortical activity to a hyperexcitable state, resulting in seizures. Interestingly, a 1978 study suggested the term “disorder of disinhibition” as a way to describe epilepsy from studies of chronic cerebellar stimulation.

Design/Methods Conducted review of cases in which cerebellar lesions, leading to disinhibition of the cerebral cortex have been implicated in the development of cortical seizures. In addition, researched cases in which cerebellar inhibition has been targeted in the treatment of seizures.

Results Fifteen articles were reviewed for this study. Of those, multiple experimental studies and case reports have shown that cerebellar lesions can cause / lead to epileptiform activity in the cortex. Animal studies have shown that cerebellar purkinje cell loss has been linked to the occurrence of seizures. In one study of patients with seizures thought to be caused by cerebellar lesions, it was shown that complete resection of these lesions resulted in 9/10 patients becoming seizure-free, while only 4/9 patients that underwent partial resection became seizure free. Novel treatments for seizures, such as deep brain stimulation have targeted cerebellar nuclei and shown to have some therapeutic benefits.

Conclusions Although the pathophysiology is not well-demonstrated, the cerebellum likely has an inherent role in inhibiting aberrant discharges that could lead to seizures in the cerebral cortex. Cerebellar lesions may cause seizures due to loss of inhibition of cortical areas. Treatments enhancing cerebellar stimulation have shown some therapeutic benefits in treating seizures.

Authors/Disclosures
Venkatraman Thulasi, MD (St. Lukes) PRESENTER	Dr. Thulasi has nothing to disclose.
Veeresh Kumar Nanjangud Shivamurthy, MBBS	No disclosure on file
Xue Ming, MD (Dept of Neurosciences)	Dr. Ming has nothing to disclose.

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