The brain is in a constant state of dynamic change, for example switching between cognitive and behavioural tasks, and between wakefulness and sleep. The brains of people with epilepsy have additional features to their dynamic repertoire, particularly the paroxysmal occurrence of seizures. Substantial effort over decades has produced a detailed description of many human epilepsies and of specific seizure types; in some instances there are known causes, sometimes highly specific such as single gene mutations, but the mechanisms of seizure onset and termination are not known. A large number of in vivo animal models and in vitro models based on animal tissues can generate seizures and seizure-like phenomena. Although in some instances there is much known about the mechanism of seizure onset and termination, across the range of models there is a bewildering range of mechanisms. There is a pressing need to bridge the gap between microscale mechanisms in experimental models and mechanisms of human epilepsies. Computational models of epilepsy have advanced rapidly, allowing dynamic mechanisms to be revealed in a computer model that can then be tested in biological systems. These models are typically simplified, leaving a need to scale up these models to the large scale brain networks in which seizures become manifest. The emerging science of connectomics provides an approach to understanding the large scale brain networks in which normal and abnormal brain functions operate. The stage is now set to couple dynamics with connectomics, to reveal the abnormal dynamics of brain networks which allow seizures to occur.
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Competing interests None.
Provenance and peer review Commissioned; externally peer reviewed.
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