The clinical expression of seizures represents the main symptomatic burden of epilepsy. Neural mechanisms of semiologic production in epilepsy, especially for complex behaviors, remain poorly known. In a framework of epilepsy as a network rather than as a focal disorder, we can think of semiology as being dynamically produced by a set of interconnected structures, in which specific rhythmic interactions, and not just anatomical localization, are likely to play an important part in clinical expression. This requires a paradigm shift in how we think about seizure organization, including from a presurgical evaluation perspective. Semiology is a key data source, albeit with significant methodological challenges for its use in research, including observer bias and choice of semiologic categories. Better understanding of semiologic categorization and pathophysiological correlates is relevant to seizure classification systems. Advances in knowledge of neural mechanisms as well as anatomic correlates of different semiologic patterns could help improve knowledge of epilepsy networks and potentially contribute to therapeutic innovations.

中文翻译：

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癫痫发作符号学

癫痫发作的临床表现代表了癫痫的主要症状负担。癫痫中符号学产生的神经机制，特别是复杂行为的神经机制，仍然知之甚少。在将癫痫视为网络而非局灶性疾病的框架中，我们可以将符号学视为由一组相互关联的结构动态产生的，其中特定的节律相互作用，而不仅仅是解剖学定位，可能发挥重要作用在临床表现上。这需要我们对癫痫发作组织的看法发生范式转变，包括从术前评估的角度。符号学是一个关键的数据来源，尽管它在研究中的使用面临着重大的方法学挑战，包括观察者偏见和符号学类别的选择。更好地理解符号学分类和病理生理学相关性与癫痫分类系统相关。神经机制知识的进步以及不同符号学模式的解剖学相关性可能有助于提高对癫痫网络的认识，并可能有助于治疗创新。