Functional anatomy kindling

Based on their suggested involvement in temporal lobe epilepsy (TLE), the amygdala and hippocampus typically have been used as kindling sites. Our recent studies have attempted to define the pathways that these two sites recruit in their progressive development of generalized convulsive seizures.

Studies done over the course of a decade (involving structural lesions using neurochemical and aspiration techniques) initially implicated the piriform cortex in that generalization process, but our final view (Kelly & McIntyre, submitted) clearly shows that the piriform cortex per se is not ubiquitously critical to the expression of stage-5 convulsive seizures.

Other recent experiments suggest that our second choice (based on several kindling and anatomy studies), the perirhinal cortex, also is not critical for such expression, although the combined presence of the piriform, perirhinal and entorhinal cortex seems to be very important.

Future work will continue this exploration by combining strategic knife cuts in particular pathways to isolate salient structures and question propagation routes using routine electrophysiogical tools and c-fos immunocytochemistry during various stages of kindling. Studies of this kind currently are indicating that quite different neural networks are involved in amygdala versus hippocampal kindling. For intervention purposes, this kind of information should be useful ultimately to the neurosurgeon in determining what structure(s) an epileptic site recruits to present itself clinically.