Department of Medicine, St. Vincent's Hospital, The University of Melbourne, Melbourne, Australia; Faculty of Information Technology, Monash University, Clayton, Australia
Mitsuyoshi Nakatani
Aix Marseille Univ, Inserm, INS, Institut de Neurosciences des Systèmes, Marseille, France, Marseille, France
Tomohiko Murai
Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, Kyoto, Japan
Matthias Dümpelmann
Epilepsy Center, Medical Center – University of Freiburg, Freiburg im Breisgau, Germany; Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
Epilepsy Center, Medical Center – University of Freiburg, Freiburg im Breisgau, Germany; Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany; Center for Basics in NeuroModulation (NeuroModul Basics), Epilepsy Center, Medical Center - University of Freiburg, Freiburg im Breisgau, Germany
Akio Ikeda
Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, Kyoto, Japan
Graeme Clark Institute, The University of Melbourne, Melbourne, Australia; Department of Medicine, St. Vincent's Hospital, The University of Melbourne, Melbourne, Australia
Department of Biomedical Engineering, BioInterfaces Institute, University of Michigan, Ann Arbor, United States; Department of Neurology, University of Michigan, Ann Arbor, United States
Seizures are a disruption of normal brain activity present across a vast range of species and conditions. We introduce an organizing principle that leads to the first objective Taxonomy of Seizure Dynamics (TSD) based on bifurcation theory. The ‘dynamotype’ of a seizure is the dynamic composition that defines its observable characteristics, including how it starts, evolves and ends. Analyzing over 2000 focal-onset seizures from multiple centers, we find evidence of all 16 dynamotypes predicted in TSD. We demonstrate that patients’ dynamotypes evolve during their lifetime and display complex but systematic variations including hierarchy (certain types are more common), non-bijectivity (a patient may display multiple types) and pairing preference (multiple types may occur during one seizure). TSD provides a way to stratify patients in complement to present clinical classifications, a language to describe the most critical features of seizure dynamics, and a framework to guide future research focused on dynamical properties.
