Commentary on Schotte et al. “Development of temporal lobe epilepsy during maintenance electroconvulsive therapy: A case of human kindling?”

Abstract

Epilepsia Open. 2019;4:206–209. wileyonlinelibrary.com/journal/epi4 Kindling is a phenomenon whereby repeated subthreshold stimulations for inducing a particular initial behavior eventually produce that behavior, and with further stimulations additional behaviors are observed.1 It is a model of learning, memory, and epileptogenesis/epilepsy; the latter is because the measured behavior is most often a seizure that becomes progressively more severe. For example, in kindling of the limbic structures in adult rodents, the Racine scale is used.2 These seizures are initially focal and then become bilateral clonic3–5 and eventually tonic (Table 1).2 In experimental studies, kindling can be induced by a variety of electrical or chemical stimuli.3,4,6–16 Another form of kindling is the progressive intensification of bilateral (probably generalized) seizures triggered by repeated administration of chemoconvulsants such as flurothyl with associated decrease in the latencies of the onset of the convulsions.17 In almost all the studies, the data suggest that focal seizures eventually become bilateral or the bilateral seizures become more severe. There Received: 14 October 2018 | Accepted: 18 October 2018 DOI: 10.1002/epi4.12296