INSERM U 398, Neurobiologie et Neuropharmacologie des épilepsies Généralisées, Faculté de Médecine, Université Louis-Pasteur, 11, rue Humann, 67085 Strasbourg Cedex, France.
Over the past few years, the role of the basal ganglia in epilepsy has been widely debated, the debate being mainly based on experimental data obtained from several animal models. In the present review, the possibility that basal ganglia circuits can generate some forms of seizure or participate to their initiation will first be addressed. In the second part of this chapter, recent data suggesting the involvement of the basal ganglia in the control of seizures will be discussed. Although it is clear that basal ganglia circuits cannot generate seizures and are unlikely to be involved in their initiation, numerous experimental data have revealed that seizures modify the activity of this system. More recently, the collection of pharmacological and electrophysiological data in animal models of epilepsy has led to the emergence of the basal ganglia as a possible control circuit for the seizures. These experimental data have already led to initial clinical trials in epileptic patients. The preliminary clinical data encourage the further development of experimental research in chronic models of epilepsy to better determine the exact output circuits involved in seizure interruption, the mechanisms participating in seizure control and whether the same circuits are involved in the control of different types of seizures. These studies may allow the identification of crucial structures and the types of epilepsy likely to benefit from this new therapeuticapproach.