Introduction from Dr Markus Reuber, editor-in-chief of Seizure
Recent insights into the pathophysiology of seizures have challenged the traditional concepts of
“focal’ and ‘generalised’ epilepsies. Many ‘focal’ epilepsies seem to involve surprisingly widespread network dysfunction whereas many ‘generalized’ seizures start from remarkably ‘focal’ beginnings. This review article by Yacubian and Wolf focuses on the phenomenon of praxis induction and explores (in neo-Jacksonian fashion) what the clinical observation that some seizures can be induced by mentally demanding activities can teach us about the connectivity and functioning of the brain. When it is looked for, the phenomenon of praxis-induced seizures is not rare. It can be observed in one quarter to one half of patients with juvenile myoclonus epilepsy (JME), although it is also encountered in other epilepsy syndromes.
Apart from providing fascinating neuroanatomical and neurophysiological insights into normal and abnormal brain function, the phenomenon of praxis induction also raises interesting philosophical questions about willed action, or the perception of ‘free will’ and the neurobiological machinery of the brain.
I therefore recommend the fascinating review to a wide neurological and non-neurological readership.
(1) Yacubian E. M. T., Wolf P. Praxis induction. Definition, relation to epilepsy syndromes, nosological and prognostic significance: a focused review. Seizure 2014:23:247-251