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EPILEPSY
The Intersection of Neurosciences,
Biology, Mathematics,
Engineering, and Physics
© 2011 by Taylor and Francis Group, LLC

EPILEPSY
The Intersection of Neurosciences,
Biology, Mathematics,
Engineering, and Physics
EDITED BY
Ivan Osorio • Hitten P. Zaveri
Mark G. Frei • Susan Arthurs
Boca Raton London New York
CRC Press is an imprint of the

Taylor & Francis Group, an informa business

MATLAB® is a trademark of The MathWorks, Inc. and is used with permission. The MathWorks does not warrant the accuracy
of the text or exercises in this book. This book’s use or discussion of MATLAB® software or related products does not consti-
tute endorsement or sponsorship by The MathWorks of a particular pedagogical approach or particular use of the MATLAB®
software.
CRC Press
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CRC Press is an imprint of Taylor & Francis Group, an Informa business
No claim to original U.S. Government works
Printed in the United States of America on acid-free paper

10 9 8 7 6 5 4 3 2 1
International Standard Book Number: 978-1-4398-3885-3 (Hardback)
This book contains information obtained from authentic and highly regarded sources. Reasonable efforts have been made to
publish reliable data and information, but the author and publisher cannot assume responsibility for the validity of all materials
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Library of Congress Cataloging-in-Publication Data
Epilepsy : the intersection of neurosciences, biology, mathematics, engineering and physics / [edited by] Ivan
Osorio … [et al.].
p. ; cm.
Includes bibliographical references and index.
Summary: “Integrating the studies of epilepsy, neurosciences, computational neurosciences, mathematics,
physics, engineering, and medicine, this volume provides the first means to a clear, structured, and enriching
multidisciplinary perspective for developing students, researchers, and clinicians in the field of epilepsy.
The text gives up to date information on the state of current research, possible future research, and clinical
directions in the fields of epilepsy and seizure dynamics. Clear illustrations that illustrate the patterns of
brain electrophysiology and behavioral manifestations are provided to aid comprehension. The authors
include extensive references in each chapter to enhance further study”--Provided by publisher.
ISBN 978-1-4398-3885-3 (hardback)
1. Epilepsy. I. Osorio, Ivan.
[DNLM: 1. Epilepsy--physiopathology. 2. Interdisciplinary Communication. 3. Predictive Value of Tests.
4. Seizures--prevention & control. WL 385]
RC372.E67276 2011
616.8’53--dc22 2011006202
Visit the Taylor & Francis Web site at

http://www.taylorandfrancis.com
and the CRC Press Web site at

http://www.crcpress.com

This book is dedicated to all epilepsy patients and their caregivers
who carry the burden of this disease and for whom we work to provide
better treatments. We also acknowledge all of the researchers from
the many disciplines and from around the world who tirelessly focus
on epilepsy in general and seizure prediction in particular.

Contents
Preface...............................................................................................................................................xi
Acknowledgments........................................................................................................................... xiii
Editors............................................................................................................................................... xv
Contributors....................................................................................................................................xvii
SECTiON I Foundations of Epilepsy
Chapter 1. Neuroanatomy as Applicable to Epilepsy: Gross and Microscopic

Anatomy/ Histology.......................................................................................................3
Taufik A. Valiante
Chapter 2. Introduction to EEG for Nonepileptologists Working in Seizure Prediction

and Dynamics.............................................................................................................. 23
Richard Wennberg
Chapter 3. Basic Mechanisms of Seizure Generation................................................................... 41

John G. R. Jefferys and Premysl Jiruska
Chapter 4. An Introduction to Epileptiform Activities and Seizure Patterns Obtained by

Scalp and Invasive EEG Recordings........................................................................... 51
Andreas Schulze-Bonhage
Chapter 5. Seizures and Epilepsy: An Overview.......................................................................... 65

Steven Weinstein
SECTiON II Foundations of Engineering, Math, and Physics
Chapter 6. Intracranial EEG: Electrodes, Filtering, Amplification, Digitization,

Storage, and Display.................................................................................................... 81
Hitten P. Zaveri and Mark G. Frei
Chapter 7. Time-Frequency Energy Analysis............................................................................... 95

Piotr J. Franaszczuk
Chapter 8. Neurodynamics and Ion Channels: A Tutorial.......................................................... 111

John G. Milton
vii

viii Contents
Chapter 9. Nonlinear Time Series Analysis in a Nutshell.......................................................... 125

Ralph G. Andrzejak
Chapter 10. How to Detect and Quantify Epileptic Seizures....................................................... 139

Sridhar Sunderam
Chapter 11. Automated Prediction and Assessment of Seizure Prediction Algorithms............... 165
Florian Mormann, Ralph G. Andrzejak, and Klaus Lehnertz
Chapter 12. Autonomous State Transitions in the Epileptic Brain: Anticipation and Control..... 175
Stiliyan N. Kalitzin, Demetrios N. Velis, and Fernando Lopes da Silva
SECTiON III The Challenge of Prediction
Chapter 13. Prediction..................................................................................................................203

Didier Sornette and Ivan Osorio
SECTiON IV The State of Seizure Prediction:

Seizure Prediction and Detection
Chapter 14. Impact of Biases in the False-Positive Rate on Null Hypothesis Testing................. 241
Ralph G. Andrzejak, Daniel Chicharro, and Florian Mormann
Chapter 15. Seizure Prediction: An Approach Using Probabilistic Forecasting.......................... 249

Bjoern Schelter, Hinnerk Feldwisch-Drentrup, Andreas Schulze-Bonhage,
and Jens Timmer
Chapter 16. Seizure Prediction and Detection Research at Optima Neuroscience...................... 257
Deng-Shan Shiau, Jui-Hong Chien, Ryan T. Kern, Panos M. Pardalos,
and J. Chris Sackellares
Chapter 17. Preictal Directed Interactions in Epileptic Brain Networks..................................... 265

Klaus Lehnertz, Dieter Krug, Matthäus Staniek, Dennis Glüsenkamp,
and Christian E. Elger
Chapter 18. Seizure Prediction and Observability of EEG Sources............................................. 273

Elma O’Sullivan-Greene, Levin Kuhlmann, Andrea Varsavsky,
David B. Grayden, Anthony N. Burkitt, and Iven M. Y. Mareels

Contents ix
Chapter 19. Circadian Regulation of Neural Excitability in Temporal Lobe Epilepsy................ 289
Paul R. Carney, Sachin S. Talathi, Dong-Uk Hwang, and William Ditto
Chapter 20. Use of Dynamical Measures in Prediction and Control of Focal and
Generalized Epilepsy................................................................................................307
Shivkumar Sabesan, Leon Iasemidis, Konstantinos Tsakalis,
David M. Treiman, and Joseph Sirven
Chapter 21. Time-Series-Based Real-Time Seizure Prediction................................................... 321

Pooja Rajdev and Pedro P. Irazoqui
Chapter 22. Optimizing Seizure Detection Algorithms toward the Development of

Implantable Epilepsy Prostheses............................................................................... 331
Shriram Raghunathan and Pedro P. Irazoqui
Chapter 23. Initiation and Termination of Seizure-Like Activity in Small-World

Neural Networks....................................................................................................... 341
Alexander Rothkegel, Christian E. Elger, and Klaus Lehnertz
Chapter 24. Are Interaction Clusters in Epileptic Networks Predictive of Seizures?.................. 349
Stephan Bialonski, Christian E. Elger, and Klaus Lehnertz
Chapter 25. Preictal Spikes in the Hippocampus of Patients with Mesial Temporal
Lobe Epilepsy............................................................................................................ 357
C. Alvarado-Rojas, M. Valderrama, G. Huberfeld, and M. Le Van Quyen
SECTiON V The State of Seizure Prediction: Seizure Generation
Chapter 26. Microanalysis and Macroanalysis of High-Frequency Oscillations in the

Human Brain............................................................................................................. 369
B. Crépon, M. Valderrama, C. Alvarado-Rojas, V. Navarro, and M. Le Van Quyen
SECTiON VI The State of Seizure Prediction: Seizure Control
Chapter 27. Vagus Nerve Stimulation Triggered by Machine Learning–Based Seizure

Detection: Initial Implementation and Evaluation.................................................... 385
Ali Shoeb, Trudy Pang, John V. Guttag, and Steven C. Schachter
Chapter 28. Low-Frequency Stimulation as a Therapy for Epilepsy............................................ 397

Jeffrey H. Goodman

x Contents
SECTiON VII The State of Seizure Prediction: Technology

Chapter 29. Large-Scale Electrophysiology: Acquisition, Storage, and Analysis........................409
Matt Stead, Mark R. Bower, Benjamin H. Brinkmann, Christopher Warren,
and Gregory A. Worrell
Chapter 30. EPILAB: A MATLAB® Platform for Multifeature and Multialgorithm

Seizure Prediction..................................................................................................... 417
B. Direito, R. P. Costa, H. Feldwisch-Drentrup, M. Valderrama,
S. Nikolopoulos, B. Schelter, M. Jachan, C. A. Teixeira, L. Aires, J. Timmer,
M. Le Van Quyen, and A. Dourado
Chapter 31. Emerging Technologies for Brain-Implantable Devices........................................... 429

Bruce Lanning, Bharat S. Joshi, Themis R. Kyriakides, Dennis D. Spencer,
and Hitten P. Zaveri
SECTiON VIII Nocturnal Frontal Lobe Epilepsy: A Paradigm

for Seizure Prediction?
Chapter 32. Familial and Sporadic Nocturnal Frontal Lobe Epilepsy
(NFLE)— Electroclinical Features........................................................................... 445
Gholam K. Motamedi and Ronald P. Lesser
Chapter 33. Nicotinic Acetylcholine Receptors in Circuit Excitability and Epilepsy:

The Many Faces of Nocturnal Frontal Lobe Epilepsy.............................................. 451
Ortrud K. Steinlein and Daniel Bertrand
Chapter 34. Channelopathies in Epileptology.............................................................................. 461

Frank Lehmann-Horn, Yvonne Weber, Snezana Maljevic, Karin Jurkat-Rott,
and Holger Lerche
Chapter 35. Autosomal Dominant Nocturnal Frontal Lobe Epilepsy: Excessive Inhibition?......469
Molly N. Brown and Gregory C. Mathews
Chapter 36. How to Measure Circadian Rhythmicity in Humans................................................ 477

Wytske A. Hofstra and Al W. de Weerd
Chapter 37. Seizure Prediction and the Circadian Rhythm......................................................... 489

Tyler S. Durazzo and Hitten P. Zaveri
Chapter 38. Nocturnal Frontal Lobe Epilepsy: Metastability in a Dynamic Disease?................ 501
John G. Milton, Austin R. Quan, and Ivan Osorio
Index............................................................................................................................................... 511

Preface
Epilepsy: The Intersection of Neurosciences, Biology, Mathematics, Engineering, and Physics con-
flates the didactic sessions, keynote lectures, and scientific presentations delivered at the Fourth
International Workshop on Seizure Prediction held in Kansas City, Missouri in the spring of 2009
and at the Sanibel Symposium (Nocturnal Frontal Lobe Epilepsy: An Interdisciplinary Perspective)
convened on Sanibel Island, Florida in the winter of 2010. The complexity and diversity of the sub-
ject matter contained in this book coupled with the contributors’ worthy efforts to meet the inherent
challenge to make its contents accessible to researchers with disparate scientific backgrounds, makes
this book a useful source for those outside the field as well those inside. Students of the dynami-
cal behavior of seizures and those aspiring to predict their occurrence with a worthwhile degree of
clinical utility and implement timely therapeutic interventions may be its greatest beneficiaries.
Of all neurological disorders, epilepsy demands of investigators the broadest and deepest knowl-
edge of dynamical, control, and system theories, knowledge that cannot be amassed without pos-
sessing a certain level of sophistication in relevant areas of physics, mathematics, and engineering.
A small but growing number of epileptologists realize that substantive progress in their field of
endeavor will not materialize without transcending conventional approaches and the insularity of
their efforts. Contributions from mathematicians, physicists, engineers, computer scientists, and
other disciplines have been welcomed and are beginning to bear fruit. This book, albeit imperfectly,
attempts to both capture and enrich the burgeoning interdisciplinary synergism in the nascent field
of dynamical epileptology by narrowing the inescapable cultural chasm that commonly fragments
multidisciplinary efforts. To address this innate risk, the meetings and the book’s contents have
been organized around five themes: 1. Foundations of Epilepsy (Chapters 1–5) introduces nonphy-
sicians to language and concepts necessary to establish a meaningful dialog with epileptologists;
2. Foundations of Engineering, Math, and Physics (Chapters 6–12) expands the fund of knowledge
of physicians into areas such as dynamical theory and signal processing without which the synthesis
of concepts and ideas into testable hypotheses would be onerous and likely barren; 3. Challenge of
Prediction (Chapter 13) delves into the issue of how to assess the degree of predictability from a
system’s behavior and the techniques required for fulfillment of this aim, by mining of knowledge
from fields devoted to the investigation of aperiodic paroxysmal phenomena, such as earthquakes,
so as to lay the proper foundations for dynamical epileptology and foster much needed growth effi-
ciently; 4. The State of Seizure Prediction, Generation and Control (Chapters 14–31) provides an
update of advancements in our understanding of the spatiotemporal behavior of seizures and of the
mechanisms of epileptogenesis and ictogenesis as well as of seizure control and ancillary technol-
ogy; and 5. Nocturnal Frontal Lobe Epilepsy: A Paradigm for Seizure Prediction? (Chapters 32–38)
calls attention to an ignored syndrome, nocturnal frontal lobe epilepsy, whose proclivity for seizures
to occur during a certain sleep stage may facilitate the task of identifying a precursory state, if exis-
tent, while markedly narrowing the search space.
The editors recognize and express their gratitude to those who generously put to pen their insights
into a spinous but intellectually stimulating field of study and to the federal and private organiza-
tions and individuals* that provided the means to foster coalescence of seemingly disparate topics,
concepts, and viewpoints into printed matter.
* See Acknowledgments for a complete list of sponsors.
xi

xii Preface
MATLAB® is a registered trademark of The MathWorks, Inc. For product information, please
contact:
The MathWorks, Inc.

3 Apple Hill Drive
Natick, MA 01760-2098 USA
Tel: 508-647-7000
Fax: 508-647-7001
E-mail: info@mathworks.com
Web: www.mathworks.com

Acknowledgments
Funding for Fourth International Workshop on Seizure Prediction and the Sanibel Symposium
(Nocturnal Frontal Lobe Epilepsy: An Interdisciplinary Perspective) was provided by the follow-
ing government agencies, foundations, companies, university and hospital partners, and individuals:
National Institutes of Health* (Grant No. R13NS065535 from the National Institute of Neurological
Disorders and Stroke, Office of Rare Diseases Research and National Institute of Child Health and
Human Development), Alliance for Epilepsy Research, UCB, Cyberonics, Deutsche Gesellschaft
für Epileptologie, NeuroVista, American Epilepsy Society, CURE, University of Kansas Medical
Center, Children's Mercy Hospitals and Clinics, Honeywell–Kansas City Plant, Ad-Tech, Cardinal
Health, Medtronic, DIXI, Boulevard Brewing Co., and Mary Shaw Branton, Don Alexander, and
Frank and Helen Wewers.
* The views expressed in this publication do not necessarily represent the official views of the National Institutes of Health,
NINDS, ORDR, or NICHD and do not necessarily reflect the official policies of the Department of Health and Human
Services; nor does mention by trade names, commercial practices, or organizations imply endorsement by the U.S.
Government.
xiii

Editors
Ivan Osorio— Ivan Osorio, a physician scientist and epileptologist, is professor of neurology at the
University of Kansas Medical Center and the R. Adams Institute of Analytical Biochemistry. He is a
Distinguished Visiting Neuroscience Professor at the Claremont Colleges’ Joint Science Department
and a visiting scholar at Harvey Mudd’s Department of Mathematics. He serves on the editorial boards
of several journals and on NINDS’ study sections.
His research interests are the characterization of the spatiotemporal behavior of seizures, the
development of intelligent devices for automated seizure detection, warning, and control, quantita-
tive real-time assessment of therapeutic efficacy and real-time optimization, and the application of
control and systems theory to the study and treatment of epilepsy.
Hitten Zaveri—Hitten P. Zaveri is an associate research scientist in the Department of Neurology

at Yale University. Dr. Zaveri has received academic training in electrical engineering (BSE,
MSE), computer engineering (BSE), and biomedical engineering (MS, PhD) from the University of
Michigan in Ann Arbor and postdoctoral training in epilepsy and neurology from Yale University.
He is the director of the Yale University Computational Neurophysiology Laboratory. His research
interests lie at the intersection of neuroscience, engineering, and mathematics.
Mark G. Frei—Mark G. Frei is the managing director and technical director of Flint Hills Scientific,
L.L.C. (FHS), a development stage research and development company in Lawrence, Kansas that
Dr. Frei cofounded in 1995. He specializes in real-time quantitative analysis, filtering, identification
and control of complex systems and signals, and in algorithm development for intelligent medical
devices. He is an inventor on more than 30 patents, including several involving epileptic seizure
detection. Prior to joining FHS, Dr. Frei was a postdoctoral fellow at the University of Kansas, in the
Kansas Institute for Theoretical and Computational Science, the Comprehensive Epilepsy Center,
and the Department of Mathematics. He received his PhD in mathematics from the University
of Kansas with research specialties in the fields of modeling, prediction, and adaptive control of
complex systems, and has authored or coauthored several scientific articles. He received his MS
in applied mathematics/electrical engineering from the University of Southern California and BA
in mathematics from the University of California Los Angeles. Prior to his doctoral training at the
University of Kansas, Dr. Frei was a member of the technical staff of TRW, Inc.
Susan Arthurs—Susan Arthurs is a former United Airlines pilot who lost her career to epilepsy.
In 1996, she cofounded the Alliance for Epilepsy Research, a 501(c)(3) charitable organization, and
is currently executive director and secretary of the board. She is director and producer of the 2009
award-winning documentary, “It Is Epilepsy: The Challenges and Promises of Automated Seizure
Control,” which was created to increase public awareness of epilepsy and provide hope for those
who have epilepsy in their lives. From 2000 to 2004, Susan was an adjunct instructor then assistant
professor in the Department of Aviation at the University of Central Missouri. She also developed
and is marketing the “Take Flight!” series of books with interactive CDs that contain ideas and
resources for aviation and space activities for Grades K through 12. Susan has a BS degree from
Penn State University in secondary mathematics education and a MS from the University of Central
Missouri in aviation safety.
xv

Contributors
L. Aires Benjamin H. Brinkmann
Faculty of Sciences and Technology Mayo Systems Electrophysiology Laboratory
University of Coimbra Division of Epilepsy and Section of
Coimbra, Portugal Electroencephalography
and
C. Alvarado-Rojas Department of Neurology
Centre de Recherche de l’Institut du Cerveau Mayo Clinic
et de la Moelle épinière Rochester, Minnesota
Hôpital de la Pitié-Salpêtrière
Paris, France Molly N. Brown
Vanderbilt University
Ralph G. Andrzejak School of Medicine
Department of Information and Nashville, Tennessee
Communication Technology
Universitat Pompeu Fabra Anthony N. Burkitt
Barcelona, Spain Department of Electrical and Electronic
Engineering
Daniel Bertrand The University of Melbourne
Department of Neuroscience Victoria, Australia
Medical Faculty
University of Geneva Paul R. Carney
Geneva, Switzerland Departments of Pediatrics, Neurology, and
Neuroscience
Stephan Bialonski and
Department of Epileptology J. Crayton Pruitt Department of Biomedical
and Engineering
Helmholtz Institute for Radiation and McKnight Brain Institute
Nuclear Physics University of Florida
and Gainesville, Florida
Interdisciplinary Center for Complex Systems
University of Bonn Daniel Chicharro
Bonn, Germany Department of Information and
Communication Technology
Mark R. Bower Universitat Pompeu Fabra
Mayo Systems Electrophysiology Laboratory Barcelona, Spain
Division of Epilepsy and Section of
Electroencephalography Jui-Hong Chien
and Optima Neuroscience, Inc.
Department of Neurology Alachua, Florida
Mayo Clinic and
Rochester, Minnesota J. Crayton Pruitt Family Department of
Biomedical Engineering
University of Florida
Gainesville, Florida
xvii

xviii Contributors
R. P. Costa Piotr J. Franaszczuk

Faculty of Sciences and Technology Department of Neurology
University of Coimbra Johns Hopkins University
Coimbra, Portugal School of Medicine
Baltimore, Maryland
B. Crépon
Centre de Recherche de l’Institut du Cerveau et Mark G. Frei
de la Moelle épinière Flint Hills Scientific, L.L.C.
Hôpital de la Pitié-Salpêtrière Lawrence, Kansas
and
Epilepsy Unit, Groupe Hospitalier Dennis Glüsenkamp
Pitié- Salpêtrière Assistance Publique Department of Epileptology
Hôpitaux de Paris and
Paris, France Helmholtz Institute for Radiation and Nuclear
Physics
Al W. de Weerd University of Bonn
Department of Clinical Neurophysiology and Bonn, Germany
Sleep Centre
Dokter Denekampweg Jeffrey H. Goodman
Zwolle, Netherlands Department of Developmental Neurobiology
New York State Institute for Basic Research
B. Direito Staten Island, New York
Faculty of Sciences and Technology and
University of Coimbra Department of Physiology and Pharmacology
Coimbra, Portugal State University of New York Downstate
Medical Center
William Ditto Brooklyn, New York
School of Biological and Health Systems
Engineering David B. Grayden
Arizona State University Department of Electrical and Electronic
Tempe, Arizona Engineering
University of Melbourne
A. Dourado Victoria, Australia
Faculty of Sciences and Technology
University of Coimbra John V. Guttag
Coimbra, Portugal Electrical Engineering and Computer Science
Department
Tyler S. Durazzo Massachusetts Institute of Technology
Yale University Cambridge, Massachusetts
New Haven, Connecticut
Wytske A. Hofstra
Christian E. Elger Department of Clinical Neurophysiology and
Department of Epileptology Sleep Centre
University of Bonn Dokter Denekampweg
Bonn, Germany Zwolle, Netherlands
Hinnerk Feldwisch-Drentrup
Bernstein Center for Computational
Neuroscience
University of Freiburg
Freiburg, Germany

Contributors xix
G. Huberfeld Karin Jurkat-Rott

Centre de Recherche de l’Institut du Cerveau Institute of Applied Physiology
et de la Moelle épinière Ulm University
Hôpital de la Pitié-Salpêtrière Ulm, Germany
and
Epilepsy Unit, Groupe Hospitalier Stiliyan N. Kalitzin
Pitié- Salpêtrière Assistance Publique Medical Physics Department
Hôpitaux de Paris Epilepsy Institute of the Netherlands
Paris, France Heemstede, Netherlands
Dong-Uk Hwang Ryan T. Kern

Korea Institute of Oriental Medicine Optima Neuroscience, Inc.
Daejeon, Republic of Korea Alachua, Florida
Leon Iasemidis Dieter Krug

Harrington Department of Bioengineering and Department of Epileptology
Electrical Engineering and
Arizona State University Helmholtz Institute for Radiation and
Tempe, Arizona Nuclear Physics
and University of Bonn
Department of Neurology Bonn, Germany
Mayo Clinic
Phoenix, Arizona Levin Kuhlmann
Department of Electrical and Electronic
Pedro P. Irazoqui Engineering
Weldon School of Biomedical Engineering University of Melbourne
Purdue University Victoria, Australia
West Lafayette, Indiana
Themis R. Kyriakides
M. Jachan Departments of Pathology and Biomedical
Albert-Ludwigs-University Engineering
Freiburg, Germany Yale University
John G. R. Jefferys
Neuronal Networks Group Bruce Lanning
School of Clinical and Experimental Medicine Thin Film Technologies
University of Birmingham ITN Energy Systems
Birmingham, United Kingdom Littleton, Colorado
Premysl Jiruska M. Le Van Quyen

Neuronal Networks Group Centre de Recherche de l’Institut du Cerveau
School of Clinical and Experimental Medicine et de la Moelle épinière
University of Birmingham Hôpital de la Pitié-Salpêtrière
Birmingham, United Kingdom Paris, France
Bharat S. Joshi Frank Lehmann-Horn

Department of Electrical and Computer Institute of Applied Physiology
Engineering Ulm University
University of North Carolina Ulm, Germany
Charlotte, North Carolina

xx Contributors
Klaus Lehnertz Florian Mormann

Department of Epileptology Department of Epileptology
and University of Bonn
Helmholtz Institute for Radiation and Bonn, Germany
Nuclear Physics
and Gholam K. Motamedi
Interdisciplinary Center for Complex Systems Department of Neurology
University of Bonn Georgetown University School of Medicine
Bonn, Germany Washington, DC
Holger Lerche V. Navarro

Department of Neurology and Epileptology Centre de Recherche de l’Institut du Cerveau
Hertie Institute of Clinical Brain Research et de la Moelle épinière
University of Tübingen Hôpital de la Pitié-Salpêtrière
Tübingen, Germany and
Epilepsy Unit, Groupe Hospitalier
Ronald P. Lesser Pitié-Salpêtrière Assistance Publique
Department of Neurology and Neurosurgery Hôpitaux de Paris
Johns Hopkins University Paris, France
School of Medicine
Baltimore, Maryland S. Nikolopoulos
Centre de Recherche de l’Institut du Cerveau et
Fernando Lopes da Silva de la Moelle épinière
Swammerdam Institute of Neuroscience Hôpital de la Pitié-Salpêtrière
University of Amsterdam Paris, France
Amsterdam, Netherlands
Elma O’Sullivan-Greene
Snezana Maljevic
Department of Electrical and Electronic
Department of Neurology and Epileptology
Engineering
Hertie Institute of Clinical Brain Research
University of Melbourne
University of Tübingen
Victoria, Australia
Tübingen, Germany
and
Iven M. Y. Mareels National Information and Communications
Department of Electrical and Electronic Technology Australia
Engineering Victorian Research Lab
University of Melbourne Melbourne, Australia
Victoria, Australia
Ivan Osorio
Gregory C. Mathews Department of Neurology
Vanderbilt University University of Kansas Medical Center
School of Medicine Kansas City, Missouri
Nashville, Tennessee
John G. Milton
W. M. Keck Science Center
Claremont Colleges
Claremont, California

Contributors xxi
Trudy Pang J. Chris Sackellares

Neurology Department Optima Neuroscience, Inc.
and Alachua, Florida
Clinical Investigator Training Program
Beth Israel Deaconess Medical Center Steven C. Schachter
and Neurology Department
Harvard/MIT Health Sciences and Technology Beth Israel Deaconess Medical Center
in collaboration with Pfizer Inc. and Merck Boston, Massachusetts
and Company
Boston, Massachusetts Bjoern Schelter
Center for Data Analysis and Modeling
Panos M. Pardalos University of Freiburg
Industrial and Systems Engineering Department Freiburg, Germany
University of Florida
Gainesville, Florida Andreas Schulze-Bonhage
Epilepsy Center
Austin R. Quan University Hospital
Harvey Mudd College Freiburg, Germany
Claremont, California
Shriram Raghunathan Deng-Shan Shiau

Weldon School of Biomedical Engineering Optima Neuroscience, Inc.
Purdue University Alachua, Florida
West Lafayette, Indiana
Ali Shoeb
Pooja Rajdev Massachusetts General Hospital
Weldon School of Biomedical Engineering Boston, Massachusetts
Purdue University and
West Lafayette, Indiana Massachusetts Institute of Technology
Cambridge, Massachusetts
Alexander Rothkegel
Department of Epileptology Joseph Sirven
and Department of Neurology
Helmholtz Institute for Radiation and Nuclear Mayo Clinic
Physics Phoenix, Arizona
and
Interdisciplinary Center for Complex Systems Didier Sornette
University of Bonn Swiss Federal Institute of Technology Zurich
Bonn, Germany and
Swiss Finance Institute
Shivkumar Sabesan Zurich, Switzerland
Department of Neurology Research
Barrow Neurological Institute Dennis D. Spencer
St. Joseph’s Hospital and Medical Center Department of Neurosurgery
Phoenix, Arizona Yale University
and New Haven, Connecticut
Harrington Department of Bioengineering
Arizona State University
Tempe, Arizona

xxii Contributors
Matthäus Staniek Konstantinos Tsakalis

Department of Epileptology Department of Electrical Engineering
and Arizona State University
Helmholtz Institute for Radiation and Nuclear Tempe, Arizona
Physics
University of Bonn M. Valderrama
Bonn, Germany Centre de Recherche de l’Institut du Cerveau et
de la Moelle épinière
Matt Stead Hôpital de la Pitié-Salpêtrière
Mayo Systems Electrophysiology Laboratory Paris, France
Electroencephalography Taufik A. Valiante
and Krembil Neuroscience Center
Department of Neurology University Health Network
Mayo Clinic Toronto Western Hospital
Rochester, Minnesota Toronto, Ontario, Canada
Ortrud K. Steinlein Andrea Varsavsky

Institute of Human Genetics Department of Otolaryngology
University Hospital, Ludwig- The University of Melbourne
Maximilians-University Victoria, Australia
Munich, Germany
Demetrios N. Velis
Sridhar Sunderam Department of Clinical Neurophysiology
Center for Biomedical Engineering and
University of Kentucky Epilepsy Monitoring Unit
Lexington, Kentucky Epilepsy Institute of the Netherlands
Heemstede, Netherlands
Sachin S. Talathi
J. Crayton Pruitt Department of Biomedical Christopher Warren
Engineering Mayo Systems Electrophysiology Laboratory
McKnight Brain Institute Division of Epilepsy and Section of
University of Florida Electroencephalography
Gainesville, Florida and
Department of Neurology
C. A. Teixeira Mayo Clinic
Faculty of Sciences and Technology Rochester, Minnesota
University of Coimbra
Coimbra, Portugal Yvonne Weber
Department of Neurology and Epileptology
Jens Timmer Hertie Institute of Clinical Brain Research
Freiburg Institute for Advanced Studies University of Tübingen
University of Freiburg Tübingen, Germany
Freiburg, Germany
Steven Weinstein
David M. Treiman Pediatric Epilepsy Center
Department of Neurology Weill Cornell Medical Center
Barrow Neurological Institute New York Presbyterian Hospital
St. Joseph’s Hospital and Medical Center New York, New York
Phoenix, Arizona

Contributors xxiii
Richard Wennberg Hitten P. Zaveri

University of Toronto Department of Neurology
Toronto, Ontario, Canada Yale University
Gregory A. Worrell
Mayo Systems Electrophysiology Laboratory
Electroencephalography
and
Department of Neurology
Mayo Clinic
Rochester, Minnesota

Section I
Foundations of Epilepsy

1 Neuroanatomy as
Applicable to Epilepsy
Gross and Microscopic
Anatomy/Histology
Taufik A. Valiante
CONTENTS
1.1 Introduction...............................................................................................................................4
1.2 Gross Anatomy..........................................................................................................................4
1.3 Cytoarchitecture........................................................................................................................6
1.4 Lobes of the Brain.....................................................................................................................7
1.4.1 Frontal Lobe..................................................................................................................7
1.4.1.1 Inferior Frontal Gyrus.....................................................................................8
1.4.1.2 Precentral Gyrus.............................................................................................8
1.4.1.3 Medial Frontal Gyrus: Supplementary Motor Area..................................... 10
1.4.1.4 Other Frontal Gyri........................................................................................ 10
1.4.1.5 Premotor Area............................................................................................... 10
1.4.1.6 Frontal Eye Fields......................................................................................... 10
1.4.1.7 Clinical Manifestations................................................................................. 10
1.4.1.8 Prefrontal Area............................................................................................. 11
1.4.2 Parietal Lobe................................................................................................................ 11
1.4.2.1 Primary Sensory Area.................................................................................. 11
1.4.3 Occipital Lobe............................................................................................................. 11
1.4.4 Temporal and Limbic Lobe......................................................................................... 12
1.4.4.1 Language and the Temporal Lobe................................................................ 13
1.4.4.2 Hearing......................................................................................................... 13
1.4.4.3 Memory......................................................................................................... 14
1.4.4.4 Amygdala...................................................................................................... 15
1.4.4.5 Clinical Manifestations of Temporal Lobe Seizures.................................... 15
1.4.5 Insula........................................................................................................................... 16
1.5 Thalamus................................................................................................................................. 16
1.6 White Matter............................................................................................................................ 18
1.6.1 Projection Fibers.......................................................................................................... 18
1.6.2 Association Fibers....................................................................................................... 19
1.6.2.1 Long Association Fibers............................................................................... 19
1.6.2.2 Commissural Fibers......................................................................................20
1.6.2.3 Short Association Fibers...............................................................................20
1.6.3 Connectivity................................................................................................................. 21
References......................................................................................................................................... 21

4 Epilepsy: The Intersection of Neurosciences, Biology, Mathematics, Engineering, and Physics
If the brain were simple enough for us to understand it, we would be too simple to understand it.
—Ken Hill
1.1 INTRODUcTiON
This is a brief summary of brain anatomy in the context of epilepsy. It reviews the gross anatomical
and some ultrastructural details as a primer for those with little or no clinical orientation. This is by
no means exhaustive, and there are ample texts for those wishing more detail (Nieuwenhuys et al.
1988; Carpenter 1991; Sheppard 2004; Andersen et al. 2007; Miller and Cummings 2007). As was
so appropriately stated during the Fourth International Workshop on Seizure Prediction (IWSP4) in
Kansas City by Walter Freeman, “We don’t have a language that describes brain function.” We are
left then with trying to describe the brain from a structural perspective and implying function from
physiological experimentation on animals and humans. It might be equally important to mention
that, along with not having a language to describe brain function, we have little way to measure
brain function—whatever that might be—if this is in fact what we are doing with various technolo-
gies currently at our disposal.
I will describe the various lobes of the brain and what structural and ultrastructural details
give rise to these anatomical demarcations. How various regions are wired together will be dealt
with through discussion of white matter tracts. Functional subregions relevant to epilepsy and its
manifestations will follow from the above lobar demarcations as well as from cellular variability
throughout the brain associated with specialized functions of these cellularly distinct regions. There
is a more generous discussion of the temporal lobe compared with other lobes, as it is the portion of
the brain that has been extensively studied in regard to epilepsy and the region most frequented by
neurosurgeons in attempts to ameliorate epilepsy.
1.2 GROSS ANaTOMY

The human brain weighs, on average, 1350 grams; however, in its native state suspended in nutri-
tious cerebrospinal fluid (CSF), it weighs only 50 grams. It is a highly ordered and exceedingly
organized structure with the majority of the brain volume being composed of cells and cellular
processes. Hence, the brain is largely composed of the internal components of cells, with only a
very narrow space (extracellular space) separating cellular components of the brain. In fact, only
about 4% of the human brain volume can be attributed to extracellular space. The remainder of the
brain volume can be attributed to neurons and glia, the two primary cellular components of the
brain. There are three primary subdivisions of the brain (see Figure 1.1): cerebrum, brain stem, and
cerebellum. The last two are not usually implicated in epilepsy and will not be discussed.
The two hemispheres (see Figure 1.2) are separated by the longitudinal or interhemispheric fis-
sure and are covered by a 2- to 5-mm layer of neurons that forms the cortex (like the bark of a tree)
or gray matter. Underlying the gray matter is white matter, which represents the cabling of the brain
and is composed of axons. Axons convey all or none events to other neurons through the generation
of action potentials that are conveyed in a metabolically efficient manner over long distances. The
termination of the axon at a synapse generates graded potentials in the postsynaptic cell that will, if
large (sufficiently depolarized) enough, cause the postsynaptic neuron to generate an action poten-
tial. There are other gray matter components—the largest being the striatum, basal ganglia, and
the thalamus—that lie within the core of the brain with interposed white matter. These gray matter
structures are not arranged in layers, like the cortex, but form clusters of neurons called ganglia.
The two hemispheres are interconnected by a very large white matter bundle called the corpus cal-
losum, which will be discussed in more detail later.
The total surface area of the cortex measures approximately 2500 cm2 (0.5 × 0.5 m), with only
one third of it being visible on the exposed surface of the brain (Douglas et al. 2004). The remainder

Neuroanatomy as Applicable to Epilepsy 5
Cerebral hemisphere
Brainstem Cerebellum
FigURE 1.1 (See color insert.) The human brain. The cerebral hemispheres are paired (not shown), as are
the cerebellar hemispheres. The brainstem is not a paired structure and is subdivided into the diencephalon,
midbrain, pons, and medulla. Only the cerebral hemispheres and the thalamus are of concern in this chapter,
as the other structures of the diencephalon have unclear roles in epilepsy. (Adapted from Nieuwenhuys, R.
et al., The Human Central Nervous System: A Synopsis and Atlas, Springer-Verlag, New York, 1988. With
permission; Carpenter, M. B., Core Text of Neuroanatomy, Williams & Wilkins, Baltimore, 1991.)
of the cortex is hidden within sulci (deep clefts) that are lined by cortex (Figure 1.2). The brain
matter between these sulci are gyri. Sulci have a somewhat constant pattern between individuals,
although this applies mainly to the larger sulci, which are called fissures. The variability of the
gyral pattern makes inferences about function from gyral topology inconsistent. Given the laminar
profile of the cortex, the electrophysiological manifestations of electrical fields generated at the top
(crowns) of the gyri will be different from those generated in the walls of the sulci (Ebersole 2003).
The engineering problems that arise from this are left to those more computationally adept than
the author. The gyri can, in certain regions of the brain, be lumped together into functionally (and
usually histologically) distinct regions called lobes. For example, the frontal lobe is demarcated
from the parietal lobe and temporal lobe by the Rolandic fissure posteriorly and the Sylvian fissure
(a) (b)
Cerebral hemispheres Cortex
Gyrus White matter
Sulcus
Basal ganglia
Longitudinal ﬁssure Thalamus
FigURE 1.2 (See color insert.) The hemispheres and general organization. (a) The two hemispheres are
separated by the longitudinal fissure. They are connected (although not visible) by the corpus callosum. The
inset shows a cross section through the brain and the underlying structure and the relationship of gyri and sulci
and how they are manifest on the surface of the brain. This can also be appreciated in (b). (b) Overall orga-
nization of the hemisphere. The cortex overlies the white matter that inspisates itself between the deep gray
matter structures of the brain—the largest of these deep gray matter structures being the striatum, basal gan-
glia, and thalamus. (Adapted from Nieuwenhuys, R. et al., The Human Central Nervous System: A Synopsis
and Atlas, Springer-Verlag, New York, 1988. With permission; Carpenter, M. B., Core Text of Neuroanatomy,
Williams & Wilkins, Baltimore, 1991. With permission.)

inferiorly, respectively. With these gross demarcations, the frontal lobe can be further partitioned
based on the sulcal pattern into various gyri (Figure 1.6).
1.3 CYTOaRcHiTEcTURE
In the context of the brain, cytoarchitectonics refers to the study of the laminar organization of the
cellular components of the brain. The neocortex has six layers with each mm3 containing approxi-
mately 50,000 neurons. It has been suggested that 1 mm2 is the smallest area of cortex that can
perform all the functions of a given cortical area (Douglas et al. 2004).
Broadly speaking, neurons can be subgrouped into those that have spines, and those that do not.
A spiny neuron, unlike a nonspiny neuron, utilizes the neurotransmitter glutamate (excitatory neuro
transmitter), whereas nonspiny neurons utilize gamma amino butyric acid (GABA) (Douglas et al.
2004). Excitation refers to the process of bringing the membrane potential of a given neuron to a
more positive potential, and is also referred to as depolarization. Inhibition is the converse of excita-
tion and is also referred to as hyperpolarization. In electrophysiology parlance, and the convention
that currents are carried by positive charges, depolarization is a result of an increase in inward cur-
rent or a decrease in outward current.
As mentioned above, the neocortex has six layers of neurons, and the cellular composition of these
layers varies across different brain regions. The various layers and their names are illustrated in Figure
1.3. Broadly speaking, there appear to be three different patterns of cellular constituents, giving rise
to cytoarchitecturally distinct types of cortex: (1) koniocortex or granular cortex of sensory areas,
which contains many granule and stellate cells; (2) agranular cortex of motor and premotor regions,
which is characterized by fewer stellate cells and more pyramidal neurons; and (3) eulaminate or
homotypical cortex, which includes much of the association cortices (a cortex that is not primary
motor or primary sensory). An example of a cytoarchitecturally distinct region is the primary motor
area, also referred to as the motor strip, which is characterized by large pyramidal neurons in layers
III and V and almost complete loss of layer 4 (Figure 1.4). In contrast to this primary motor area, the
primary visual cortex, which is a primary sensory area, is characterized by a very prominent layer 4
Layer I: Molecular layer
Layer II: External granular
Layer III: External pyramidal
Layer IV: Internal granular
Layer V: Internal pyramidal
Layer VIa: Multiform
Layer VIb: Multiform
FigURE 1.3 Laminar structure of the cortex. A histological section through the human brain display-
ing the various layers. (From Nieuwenhuys, R. et al., The Human Central Nervous System: A Synopsis and
Atlas, Springer-Verlag, New York, 1988; Carpenter, M. B., Core Text of Neuroanatomy, Williams & Wilkins,
Baltimore, 1991. With permission.)

BA 6, Frontal BA 4 BA 46, Frontal

agranular region (Motor strip) granular region
Line of Gennari
BA 17, Primary visual cortex
FigURE 1.4 (See color insert.) Regional variability of cortical layering. Three different functional regions
are depicted, and their variability in cortical layering. BA 6, or the premotor area, is just one sulcus anterior
to the motor strip (primary motor area, BA 6) but lacks the large Betz cells of layer V that are characteristic
of the primary motor area. BA 4 has a paucity of inputs from sensory and associational areas and thus has a
less conspicuous layer IV, which is more prominent in the BA 46 (dorsolateral prefrontal cortex). In BA 17 (in
the occipital lobe), note the very prominent black line (line of Gennari) noted in a gross specimen (not a histo-
logical specimen) that is visible without the aid of magnification. This line corresponds to the very prominent
layer IV, where the massive thalamic input terminates. The numbers on the hemisphere do not correspond to
Brodmann areas. (From Nieuwenhuys, R. et al., The Human Central Nervous System: A Synopsis and Atlas,
Springer-Verlag, New York, 1988. With permission; Carpenter, M. B., Core Text of Neuroanatomy, Williams
& Wilkins, Baltimore, 1991. With permission.)
(due to the massive thalamic input from the lateral geniculate nucleus) that is visible with the unaided
eye (Figure 1.4). In all areas of the brain, layer IV is where input from the thalamus arrives.
The primary motor and primary visual areas are but two examples of 52 cytoarchitecturally dis-
tinct regions of the brain described by Brodmann, a German neurologist (Brodmann 1909). These
areas also bear a close relationship to functionally distinct brain regions despite being characterized
solely by their cytoarchitectural features. For example, the primary motor area is also known as
Brodmann area 4, or BA 4, and the primary visual area is BA 17. This structural regional descrip-
tion will be useful when describing functional specialization within the brain.
1.4 LOBES Of THE BRaiN

In this section, I review six lobes of the brain (Figure 1.5), one of which is not truly a lobe, as it is
a combination of varied structures and is, thus, a synthetic lobe. Enumerated, these are the frontal,
parietal, occipital, temporal, insular, and limbic lobes (synthetic).
1.4.1 FRONTAL LOBE

The frontal lobe is demarcated anatomically from the other frontal lobes by the longitudinal fissure
medially and from the parietal lobe posteriorly by the Rolandic fissure. It is the largest of the lobes

Central sulcus
(Rolandic fissure)
Parietal lobe
Parieto-occipital Frontal lobe
sulcus
Insula
“Limbic lobe”
Cingulate gyrus
Occipital lobe Frontal Parieto-occipital
“pole” sulcus
Callosal sulcus
Occipito-temporal Lingual sulcus
notch Lateral sulcus Rhinal sulcus
Temporal lobe Collateral sulcus
(Sylvian fissure)
FigURE 1.5 (See color insert.) Lobes of the brain. Various colors demarcate the different lobes of the brain.
Some lobes are demarcated from other lobes by sulci and fissures (deep sulci), whereas others may have rather
indistinct margins. The limbic lobe is a conglomerate of a number of disparate, although functionally related,
gyri and subcortical structures. It is thus referred to as a synthetic lobe. The insula is shown hidden under the
temporal and frontal gyri in a cutaway. The coronal section of the brain is taken along the dotted line. (From
Nieuwenhuys, R. et al., The Human Central Nervous System: A Synopsis and Atlas, Springer-Verlag, New
York, 1988. With permission; Carpenter, M. B., Core Text of Neuroanatomy, Williams & Wilkins, Baltimore,
1991. With permission.)
of the brain comprising one third of the hemispheric surface. From an epilepsy surgery perspective,
it is the second most common lobe in which epilepsy surgery is performed.
1.4.1.1 Inferior Frontal Gyrus

The three gyri on the lateral surface of the frontal lobe are numbered from 1 to 3 and enumerated
as F1, F2, and F3 (the F indicating frontal) (Figure 1.6a and 1.6d). These are also referred to as the
superior, middle, and inferior frontal gyri, respectively. The inferior frontal gyrus, or F3, is function-
ally unique, as it “contains Broca’s area,” a region within the dominant hemisphere that is important
for the production of speech (see Figure 1.10). Hemispheric dominance refers to the hemisphere in
which verbal functions reside, including the reception and transmission of language, which is usu-
ally on the left side of the brain. Broca’s area is comprised of two of the three parts (pars) of the
inferior frontal gyrus: the pars triangularis and the pars opercularis (Figure 1.6a). There is a third
part of F3 termed the pars orbitalis, which is usually not involved in speech generation. It was by
studying the brain of an individual with damage to this area that Broca deduced this region of the
brain to be involved in speech production. At the time of this discovery, there was ongoing debate
as to whether the bumps on an individual’s head could be used to localize brain function, an area
of study called phrenology. To this Broca remarked, “I thought that if ever there were a science of
phrenology, this was the phrenology of the convolutions, and not the phrenology of bumps” (Broca
1861). The disorder of speech generated by damage to this area is termed a nonfluent aphasia, as the
individual’s speech generation is impaired.
1.4.1.2 Precentral Gyrus

The precentral gyrus, also known as the motor strip, has already been mentioned. It resides just
anterior to the Rolandic fissure (central sulcus), being the most posterior gyrus of the frontal lobe
(Figure 1.6b). This is the primary motor area, the major output center to bulbar (brainstem) and spi-
nal motor neurons that are involved in generating voluntary motor activity. The organization of the
motor strip is somatotopically organized, which means that neighboring neurons within the motor
strip control neighboring body parts and, thus, the physical organization of the motor strip is similar
to the physical organization of the human body (Penfield and Rasmussen 1950). This functional spe-
cialization of the motor strip is mirrored by its cytoarchitectural organization, being characterized

(a) (b) Precentral gyrus

Inferior frontal gyrus (F3)
Precentral Central
sulcus sulcus
Pars opercularis
Pars orbitalis Pars triangularis
(c) (d)
Other frontal gyri
Supplementary Motor Area (SMA)
Superior frontal (F1)
Motor
strip
Superior frontal (F2) Orbitofrontal gyri
Premotor Area
(e)
Frontal eye fields (8αβδ)
FigURE 1.6 (See color insert.) Various frontal gyri and functional regions within the frontal lobe. (a) The
inferior frontal gyrus and its various divisions are shown as a darker blue. Pars orbitalis and pars triangularis
comprise Broca’s area. (b) Precentral gyrus, also known as the motor strip, is shown in dark blue and is demar-
cated anteriorly by the precentral sulcus and posteriorly by the central sulcus (also known as the Rolandic fis-
sure). (c) The supplementary motor area (SMA) and its continuation on the lateral surface of the hemisphere as
the premotor area. (d) Other frontal gyri, superior (F1), middle (F2), and orbitofrontal. (e) Frontal eye fields, BA
8αβδ, involved in voluntary movements of the eyes. (From Nieuwenhuys, R. et al., The Human Central Nervous
System: A Synopsis and Atlas, Springer-Verlag, New York, 1988. With permission; Carpenter, M. B., Core Text
of Neuroanatomy, Williams & Wilkins, Baltimore, 1991.)
by large layer V pyramidal neurons called Betz cells. During surgery, this region can be stimulated
with current, giving rise to motor responses that aid in its identification (Penfield and Rasmussen
1950). The movements that result from stimulating this area are usually simple rudimentary move-
ments of the limbs, hands, and face. It has the lowest threshold for generating an electrophysiologi-
cal response of any other region of the brain. The output of this region is via the corticospinal tract,
a white matter projection system that will be described later.
At this point, it is likely obvious to the reader that there are specific areas of the brain that appear
to be dedicated to specific functions. This was not always so obvious, and it was the pioneering
work of two German physicians, Fritsch and Hitzig, who in 1870 showed not only that, “One part
of the convexity of the cerebrum of the dog is motor (this expression is used in the sense of Shiff),
another part is not motor,” but the brain is also electrically excitable (Fristsch and Hitzig 1870). In
their experiments that were carried out in the home of one of the physicians’ mothers, the exposed
cerebrum of the dog was shown to be excitable by stimulation with electrical current via bipolar
electrodes and observation of motor activity in the limbs of the animal. The localization of cerebral
function was refined in animals by Ferrier (1876) and then brought into the realm of the human

brain by Wilder Penfield. Penfield was able to map the human brain in conscious patients during
surgery for epilepsy by electrically stimulating the brain and having the patient explain their feel-
ings or observing their movements. Through this, he was able to essentially map out important
cerebral functions including sensory, motor, speech, vision, hearing, memory, sensory perceptions,
and dreams (Penfield and Rasmussen 1950).
1.4.1.3 Medial Frontal Gyrus: Supplementary Motor Area

The supplementary motor area (SMA), which was identified by Penfield, is in the medial aspect of
the hemisphere, just anterior to the primary motor area (Figure 1.6c). When stimulated, it produces
motor activity different from that obtained from stimulation of the motor strip in that it creates syn-
ergistic movements of a large number of muscle groups on the side opposite to the stimulation. This
area of the brain is likely involved in the programming of complex motor movements, the initiation
of movements, and the coordination of bimanual activity. This region is also somatotopically orga-
nized. Removal of this area results in a transient paralysis of the opposite (contralateral) side of the
body and, if the dominant SMA is removed, there is transient mutism as well.
1.4.1.4 Other Frontal Gyri

The other frontal gyri, F2, F3, and orbital gyri, do not have somatotopically and uniquely localized
functions (Figure 1.6d). What appears to be the case for these gyri is that portions of them combine
into functionally and cytoarchitecturally discrete regions and are better demarcated by Brodmann
areas than gyral anatomy.
1.4.1.5 Premotor Area

The premotor area is a continuation of the SMA, but on the lateral aspect of the hemisphere (see
Figure 1.6c). This region is referred to as BA 6 and lies in the precentral gyrus, spanning a number
of the frontal gyri, anterior to the motor strip, which is BA 4. Cytoarchitecturally, it is referred to
as agranular cortex, since it lacks layer 4. This region is involved in sensorially guided voluntary
movements (Geschwind and Iacoboni 2007). Neurons in this region are also activated by visual,
auditory, and somotosensory stimuli. Electrophysiologically, this region has a higher threshold than
the motor strip, and cytoarchitecturally it resembles the primary motor area, except that it does not
contain Betz cells.
1.4.1.6 Frontal Eye Fields

This small region of the frontal lobe in BA 8αβδ is thought to be involved in voluntary eye move-
ments in the absence of visual stimuli; for example, the initiation of purposeful rapid eye movements
toward a target in the visual field—also known as saccades (Figure 1.6e) (Boxer 2007). Stimulation
of this area causes deviation of the eyes away from the side of stimulation. It is thus thought that this
region generates the “versive” or eye movements away from the side where a seizure is occurring.
1.4.1.7 Clinical Manifestations

The clinical manifestations of seizures arising from the various frontal regions relate to either an
excessive activation of this region during the seizure or underactivity during periods between seizures
(interictal periods). For example, a seizure that begins in the motor strip will be accompanied by
repetitive movement of the part of the body in which the excessive synchronous activity is occurring.
Likewise, a seizure focus within the frontal lobe may manifest in the interictal period as changes in
frontal lobe function related to the planning or sequencing of daily events—a cognitive process that
falls under the rubric of executive function. Another example would be a seizure within the frontal
lobe involving the frontal eye fields, which would cause the eyes to deviate to the side opposite to
where the seizure is occurring—so-called versive movement of the eyes. Conversely, during the inter-
ictal period, one might observe saccadic smooth pursuit, where the eyes make small jumps as one
tracks a moving object rather than smoothly following the tracked object.

1.4.1.8 Prefrontal Area

This is an exceedingly expansive region that is thought to involve such diverse functions as atten-
tion, awareness, personality, emotion, sensory perception, speech and language, memory, and exec-
utive function.
1.4.2 PARIETAL LOBE

1.4.2.1 Primary Sensory Area
Juxtaposed to the primary motor area in the frontal lobe, and just behind the Rolandic fissure, is the
primary sensory area (Figure 1.7). Like the primary motor area, it is somatotopically organized and
is involved in discriminative touch sensation. It is composed of three Brodmann areas: BA 3, 1, 2.
Area 3a receives information from area 1a muscle afferents and BA 3b from cutaneous stimuli. Area
1a receives a combination of cutaneous and deep receptor input and area 2 receives information
from stretch receptors (Carpenter 1991). It is beyond the scope of this chapter to detail the sensory
system; however, this region is the termination of thalamic efferents (thalamic outputs) that send
sensory stimuli to the brain. Information that arrives here includes fine touch and vibration sensa-
tion, and the position sense of the joints that is required for accurate guidance of limb movement.
Some pain information arrives here, albeit pain sensation is primarily processed in other parts of
the brain.
When this area of the brain is stimulated, for example, while surgery is being performed in and
around this region, the individual will describe a sensation of tingling, numbness, or electricity.
Pain is never experienced here during electrical stimulation of this area of the brain. Removal of
this area can be functionally devastating for the individual. Although motor strength is preserved,
the limb is extremely hard to control as feedback during voluntary activity is lost, and the limb will
often flail about violently.
1.4.3 OCCIpITAL LOBE
The occipital lobe is the lobe of the brain that is primarily involved in visual perception (Figure
1.8). On the lateral surface of the brain, its demarcations from the temporal lobe are not distinct
(Figure 1.5) as there is no sulcal boundary between these two lobes. Medially, however, it is clearly
demarcated from the parietal lobe by the parieto-occipital sulcus.
(a) (b)
Primary sensory area Primary sensory area
(“sensory strip”) Central sulcus (“sensory strip”)
(Rolandic fissure) Paracentral lobule
Marginal sulcus
Mo Motor
t strip
Precuneus
or s
trip
Postcentral sulcus
FigURE 1.7 (See color insert.) Primary sensory area. (a) Lateral view of the primary sensory area in dark
yellow, separated from the motor strip by the central sulcus. (b) It continues, as does the primary motor area
on the medial aspect of the hemisphere. The motor strip plus the sensory area are together referred to as the
paracentral lobule (outlined in orange). (From Nieuwenhuys, R. et al., The Human Central Nervous System:
A Synopsis and Atlas, Springer-Verlag, New York, 1988. With permission; Carpenter, M. B., Core Text of
Neuroanatomy, Williams & Wilkins, Baltimore, 1991.)

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gulf of crime. Having resolved on the means to be employed in the
murder, she sent for a quondam servant of her father, Robert Weir,
who lived in the neighbouring city. He came to the place of
Waristoun, to see her; but it appeares her resolution failed, and he
was not admitted. She again sent for him, and he again went. Again
he was not admitted. At length, on his being called a third time, he
was introduced to her presence. Before this time she had found an
accomplice in the nurse of her child. It was then arranged that Weir
should be concealed in a cellar till the dead of night, when he should
come forth, and proceed to destroy the laird as he lay in his chamber.
The bloody tragedy was acted precisely in accordance with this plan.
Weir was brought up at midnight from the cellar to the hall by the
lady herself, and afterwards went forward alone to the laird’s
bedroom. As he proceeded to his bloody work, she retired to her bed,
to wait the intelligence of her husband’s murder. When Weir entered
the chamber, Waristoun awoke with the noise, and leant inquiringly
over the bed. The murderer then leapt upon him. The unhappy man
uttered a great cry. Weir gave him some severe blows on vital parts,
particularly one on the flank vein. But as the laird was still able to cry
out, he at length saw fit to take more effective measures. He seized
him by the throat with both hands, and, compressing that part with
all his force, succeeded, after a few minutes, in depriving him of life.
When the lady heard her husband’s first death-shout, she leapt out
of bed, in an agony of mingled horror and repentance, and
descended to the hall; but she made no effort to countermand her
mission of destruction. She waited patiently till Weir came down to
inform her that all was over. Weir made an immediate escape from
justice, but Lady Waristoun and the nurse were apprehended before
the deed was half-a-day old. Being caught, as the Scottish law terms
it, “red-hand,”—that is, while still bearing unequivocal marks of guilt,
—they were immediately tried by the magistrates of Edinburgh, and
sentenced to be strangled and burnt at the stake.
The lady’s father, the Laird of Dunipace, who was a favourite of
King James VI., made all the interest he could with his Majesty to
procure a pardon; but all that could be obtained from the king was
an order that the unhappy lady should be executed by decapitation,
and that at such an early hour in the morning as to make the affair as
little of a spectacle as possible. The space intervening between her
sentence and her execution was only thirty-seven hours, yet in that
little time Lady Waristoun contrived to become converted from a
blood-stained and unrelenting murderess into a perfect saint on
earth. One of the then ministers of Edinburgh has left an account of
her conversion, which was lately published, and would be extremely
amusing, were it not for the loathing which seizes the mind on
beholding such an instance of perverted religion. She went to the
scaffold with a demeanour which would have graced a martyr. Her
lips were incessant in the utterance of pious exclamations. She
professed herself confident of everlasting happiness. She even
grudged every moment which she spent in this world as so much
taken from that sum of eternal felicity which she was to enjoy in the
next. The people who came to witness the last scene, instead of
having their minds inspired with a salutary horror for her crime,
were engrossed in admiration of her saintly behaviour, and greedily
gathered up every devout word which fell from her tongue. It would
almost appear, from the narrative of the clergyman, that her fate was
rather a matter of envy than of any other feeling. Her execution took
place at four in the morning of the 5th of July, at the Watergate, near
Holyrood-house; and at the same hour her nurse was burned on the
Castlehill. It is some gratification to know that the actual murderer,
Weir, was eventually seized and executed, though not till four years
afterwards.—Chambers’s Edinburgh Journal, 1832.
A TALE OF PENTLAND.
By James Hogg, the “Ettrick Shepherd.”
Mr John Haliday having been in hiding on the hills, after the battle
of Pentland, became impatient to hear news concerning the
sufferings of his brethren who had been in arms; and in particular, if
there were any troops scouring the district in which he had found
shelter. Accordingly, he left his hiding-place in the evening, and
travelled towards the valley until about midnight, when, coming to
the house of Gabriel Johnstone, and perceiving a light, he
determined on entering, as he knew him to be a devout man, and one
much concerned about the sufferings of the Church of Scotland.
Mr Haliday, however, approached the house with great caution, for
he rather wondered why there should be a light there at midnight,
while at the same time he neither heard psalms singing nor the
accents of prayer. So, casting off his heavy shoes, for fear of making a
noise, he stole softly up to the little window from whence the light
beamed, and peeped in, where he saw, not Johnstone, but another
man, whom he did not know, in the very act of cutting a soldier’s
throat, while Johnstone’s daughter, a comely girl, about twenty years
of age, was standing deliberately by, and holding the candle to him.
Haliday was seized with an inexpressible terror; for the floor was
all blood, and the man was struggling in the agonies of death, and
from his dress he appeared to have been a cavalier of some
distinction. So completely was the Covenanter overcome with horror,
that he turned and fled from the house with all his might. So much
had Haliday been confounded that he even forgot to lift his shoes,
but fled without them; and he had not run above half a bowshot
before he came upon two men hastening to the house of Gabriel
Johnstone. As soon as they perceived him running towards them
they fled, and he pursued them; for when he saw them so ready to
take alarm, he was sure they were some of the persecuted race, and
tried eagerly to overtake them, exerting his utmost speed, and calling
on them to stop. All this only made them run faster; and when they
came to a feal-dyke they separated, and ran different ways, and he
soon thereafter lost sight of them both.
This house, where Johnstone lived, is said to have been in a lonely
concealed dell, not far from West Linton, in what direction I do not
know, but it was towards that village that Haliday fled, not knowing
whether he went, till he came to the houses. Having no
acquaintances here whom he durst venture to call up, and the
morning having set in frosty, he began to conceive that it was
absolutely necessary for him to return to the house of Gabriel
Johnstone, and try to regain his shoes, as he little knew when or
where it might be in his power to get another pair. Accordingly, he
hasted back by a nearer path, and coming to the place before it was
day, found his shoes. At the same time he heard a fierce contention
within the house, but as there seemed to be a watch he durst not
approach it, but again made his escape.
Having brought some victuals along with him, he did not return to
his hiding-place that day, which was in a wild height, south of Biggar,
but remained in the moss of Craigengaur; and as soon as it drew
dark, descended again into the valley. Again he perceived a light in
the distance, where he thought no light should have been. But he
went towards it, and as he approached he heard the melody of
psalm-singing issuing from the place, and floating far on the still
breeze of the night. He hurried to the spot, and found the reverend
and devout Mr Livingston, in the act of divine worship, in an old void
barn on the lands of Slipperfield, with a great number of serious and
pious people, who were all much affected both by his prayers and
discourse.
After the worship was ended, Haliday made up to the minister,
among many others, to congratulate him on the splendour of his
discourse, and implore “a further supply of the same milk of
redeeming grace, with which they found their souls nourished,
cherished, and exalted.” The good man complied with the request,
and appointed another meeting at the same place on a future night.
Haliday having been formerly well acquainted with the preacher,
convoyed him on his way home, where they condoled with one
another on the hardness of their lots; and Haliday told him of the
scene he had witnessed at the house of Gabriel Johnstone. The heart
of the good minister was wrung with grief, and he deplored the
madness and malice of the people who had committed an act that
would bring down tenfold vengeance on the heads of the whole
persecuted race. At length it was resolved between them that, as soon
as it was day, they would go and reconnoitre, and if they found the
case of the aggravated nature they suspected, they would themselves
be the first to expose it, and give the perpetrators up to justice.
Accordingly, next morning they took another man into the secret,
a William Rankin, one of Mr Livingston’s elders, and the three went
away to Johnstone’s house, to investigate the case of the cavalier’s
murder; but there was a guard of three armed men opposed them,
and neither promises nor threatenings, nor all the minister’s
eloquence, could induce them to give way one inch. The men advised
the intruders to take themselves off, lest a worse thing should befall
them; and as they continued to motion them away, with the most
impatient gestures, the kind divine and his associates thought meet
to retire, and leave the matter as it was; and thus was this mysterious
affair hushed up in silence and darkness for that time, no tongue
having been heard to mention it further than as above recited. The
three armed men were all unknown to the others, but Haliday
observed that one of them was the very youth whom he saw cutting
off the soldier’s head with a knife.
The rage and cruelty of the Popish party seemed to gather new
virulence every day, influencing all the counsels of the king; and the
persecution of the Nonconformists was proportionably severe. One
new act of council was issued after another, all tending to root the
Covenanters out of Scotland, but it had only the effect of making
their tenets still dearer to them. The longed-for night of the meeting
in the old hay-barn at length arrived, and it was attended by a still
greater number than on the night preceding. A more motley group
can hardly be conceived than appeared in the barn that night, and
the lamps being weak and dim rendered the appearance of the
assembly still more striking. It was, however, observed that about the
middle of the service a number of fellows came in with broad slouch
bonnets, and watch-coats or cloaks about them, who placed
themselves in equal divisions at the two doors, and remained without
uncovering their heads, two of them being busily engaged taking
notes. Before Mr Livingston began the last prayer, however, he
desired the men to uncover, which they did, and the service went on
to the end; but no sooner had the minister pronounced the word
Amen, than the group of late comers threw off their cloaks, and
drawing out swords and pistols, their commander, one General
Drummond, charged the whole congregation in the king’s name to
surrender.
A scene of the utmost confusion ensued. The lights being
extinguished, many of the young men burst through the roof of the
old barn in every direction, and though many shots were fired at
them in the dark, great numbers escaped; but Mr Livingston and
other eleven were retained prisoners, and conveyed to Edinburgh,
where they were examined before the council and cast into prison.
Among the prisoners were Mr Haliday and the identical young man
whom he had seen in the act of murdering the cavalier, and who
turned out to be a Mr John Lindsay, from Edinburgh, who had been
at the battle of Pentland, and in hiding afterwards.
Great was the lamentation for the loss of Mr Livingston, who was
so highly esteemed by his hearers. The short extracts from his
sermons in the barn, that were produced against him on his trial,
prove him to have been a man endowed with talents somewhat above
the greater part of his contemporaries. His text that night it appears
had been taken from Genesis:—“And God saw the wickedness of man
that it was great in the earth, and that every imagination of the
thoughts of his heart was only evil continually.” One of the quoted
passages concludes thus:—
“Let us join together in breaking the bands of the oppressors, and
casting their cords from us. As for myself, as a member of this poor
persecuted Church of Scotland, and an unworthy minister of it, I
hereby call upon you all, in the name of God, to set your faces, your
hearts, and your hands against all such acts, which are or shall be
passed against the covenanted work of reformation in this kingdom;
that we here declare ourselves free of the guilt of them, and pray that
God may put this in record in heaven.”
These words having been sworn to, and Mr Livingston not denying
them, a sharp debate arose in the council what punishment to award.
The king’s advocate urged the utility of sending him forthwith to the
gallows; but some friends in the council got his sentence commuted
to banishment; and he was accordingly banished the kingdom. Six
more, against whom nothing could be proven farther than their
having been present at a conventicle, were sentenced to
imprisonment for two months; among this number, Haliday was one.
The other five were condemned to be executed at the cross of
Edinburgh, on the 14th of December following; and among this last
unhappy number was Mr John Lindsay.
Haliday now tried all the means he could devise to gain an
interview with Lindsay, to have some explanation of the
extraordinary scene he had witnessed in the cottage at midnight, for
it had made a fearful impression upon his mind, and he never could
get rid of it for a moment; having still in his mind’s eye a beautiful
country maiden standing with a pleased face, holding a candle, and
Lindsay in the meantime at his horrid task. His endeavours,
however, were all in vain, for they were in different prisons, and the
jailer paid no attention to his requests. But there was a gentleman in
the privy council that year, whose name, I think, was Gilmour, to
whose candour Haliday conceived that both he and some of his
associates owed their lives. To this gentleman, therefore, he applied
by letter, requesting a private interview with him, as he had a
singular instance of barbarity to communicate, which it would be
well to inquire into while the possibility of doing so remained, for the
access to it would soon be sealed for ever. The gentleman attended
immediately, and Haliday revealed to him the circumstances
previously mentioned, stating that the murderer now lay in the
Tolbooth jail, under sentence of death.
Gilmour appeared much interested, as well as astonished at the
narrative, and taking out a note-book, he looked over some dates,
and then observed—“This date of yours tallies exactly with one of my
own, relating to an incident of the same sort; but the circumstances
narrated are so different, that I must conceive either that you are
mistaken, or that you are trumping up this story to screen some
other guilty person or persons.”
Haliday disclaimed all such motives, and persevered in his
attestations. Gilmour then took him along with him to the Tolbooth
prison, where the two were admitted to a private interview with the
prisoner, and there charged him with the crime of murder in such a
place and on such a night; but he denied the whole with disdain.
Haliday told him that it was in vain for him to deny it, for he beheld
him in the very act of perpetrating the murder with his own eyes,
while Gabriel Johnstone’s daughter stood deliberately and held the
candle to him.
“Hold your tongue, fellow!” said Lindsay, disdainfully, “for you
know not what you are saying. What a cowardly dog you must be by
your own account! If you saw me murdering a gentleman cavalier,
why did you not rush in to his assistance?”
“I could not have saved the gentleman then,” said Haliday, “and I
thought it not meet to intermeddle in such a scene of blood.”
“It was as well for you that you did not,” said Lindsay.
“Then you acknowledge being in the cottage of the dell that night?”
said Gilmour.
“And if I was, what is that to you? Or what is it now to me or any
person? I was there on the night specified; but I am ashamed of the
part I there acted, and am now well requited for it. Yes, requited as I
ought to be, so let it rest; for not one syllable of the transaction shall
any one hear from me.”
Thus they were obliged to leave the prisoner, and forthwith
Gilmour led Haliday up a stair to a lodging in the Parliament Square,
where they found a gentleman lying sick in bed, to whom Mr
Gilmour said, after inquiring after his health, “Brother Robert, I
conceive that we two have found out the young man who saved your
life at the cottage among the mountains.”
“I would give the half that I possess that this were true,” said the
sick gentleman. “Who or where is he?”
“If I am right in my conjecture,” said the privy councillor, “he is
lying in the Tolbooth jail, under sentence of death, and has but a few
days to live. But tell me, brother, could you know him, or have you
any recollection of his appearance?”
“Alas! I have none,” said the other, mournfully, “for I was
insensible, through the loss of blood, the whole time I was under his
protection; and if I ever heard his name I have lost it, the whole of
that period being a total blank in my memory. But he must be a hero
in the first rank; and therefore, oh, my dear brother, save him
whatever his crime may be.”
“His life is justly forfeited to the laws of his country, brother,” said
Gilmour, “and he must die with the rest.”
“He shall not die with the rest if I should die for him,” cried the
sick man, vehemently. “I will move heaven and earth before my
brave deliverer shall die like a felon.”
“Calm yourself, brother, and trust that part to me,” said Gilmour.
“I think my influence saved the life of this gentleman, as well as the
lives of some others, and it was all on account of the feeling of
respect I had for the party, one of whom, or, rather, two of whom,
acted such a noble and distinguished part toward you. But pray,
undeceive this gentleman by narrating the facts to him, in which he
cannot fail to be interested.” The sick man, whose name, if I
remember aright, was Captain Robert Gilmour, of the volunteers,
then proceeded as follows:—
“There having been high rewards offered for the apprehension of
some south-country gentlemen, whose correspondence with Mr
Welch, and some other of the fanatics, had been intercepted, I took
advantage of information I obtained regarding the place of their
retreat, and set out, certain of apprehending two of them at least.
“Accordingly, I went off one morning about the beginning of
November, with only five followers, well armed and mounted. We
left Gilmerton long before it was light, and having a trusty guide,
rode straight to their hiding-place, where we did not arrive till
towards the evening, when we started them. They were seven in
number, and were armed with swords and bludgeons; but, being
apprized of our approach, they fled from us, and took shelter in a
morass, into which it was impossible to follow them on horseback.
But perceiving three more men on another hill, I thought there was
no time to lose, so giving one of my men our horses to hold, the rest
of us advanced into the morass with drawn swords and loaded horse-
pistols. I called to them to surrender, but they stood upon their
guard, determined on resistance; and just when we were involved to
the knees in the mire of the morass, they broke in upon us, pell-mell,
and for about two minutes the engagement was very sharp. There
was an old man struck me a terrible blow with a bludgeon, and was
just about to repeat it, when I brought him down with a shot from my
pistol. A young fellow then ran at me with his sword, and as I still
stuck in the moss, I could not ward the blow, so that he got a fair
stroke at my neck, meaning, without doubt, to cut off my head; and
he would have done it had his sword been sharp. As it was, he cut it
to the bone, and opened one of the jugular veins. I fell; but my men
firing a volley in their faces, at that moment they fled. It seems we
did the same, without loss of time; for I must now take my narrative
from the report of others, as I remember no more that passed. My
men bore me on their arms to our horses, and then mounted and
fled, trying all that they could to stanch the bleeding of my wound.
But perceiving a party coming down a hill, as with the intent of
cutting off their retreat, and losing all hopes of saving my life, they
carried me into a cottage in a wild lonely retreat, commended me to
the care of the inmates; and after telling them my name, and in what
manner I had received my death wound, they thought proper to
provide for their own safety, and so escaped.
“The only inmates of that lonely house, at least at that present
time, were a lover and his mistress, but intercommuned Whigs; and
when my men left me on the floor, the blood, which they had
hitherto restrained in part, burst out afresh and deluged the floor.
The young man said it was best to put me out of my pain, but the girl
wept and prayed him rather to render me some assistance. ‘Oh,
Johnny, man, how can you speak that gate?’ cried she. ‘Suppose he
be our mortal enemy, he is aye ane o’ God’s creatures, an’ has a soul
to be saved as well as either you or me; and a soldier is obliged to do
as he is bidden. Now Johnny, ye ken ye were learned to be a doctor o’
physic; wad ye no rather try to stop the bleeding, and save the young
officer’s life, as either kill him, or let him bleed to death on our floor,
when the blame o’ the murder might fa’ on us!’
“‘Now, the blessing of heaven light on your head, my dear Sally!’
said the lover, ‘for you have spoken the very sentiments of my heart;
and, since it is your desire, though we should both rue it, I here vow
to you that I will not only endeavour to save his life, but I will defend
it against our own party to the last drop of my blood.’
“He then began, and, in spite of my feeble struggles, who knew not
either what I was doing or suffering, sewed up the hideous gash in
my throat and neck, tying every stitch by itself; and the house not
being able to produce a pair of scissors, it seems that he cut off all the
odds and ends of the stitching with a large sharp gully knife, and it
was likely to have been during the operation that this gentleman
chanced to look in at the window. He then bathed the wound for an
hour with cloths dipped in cold water, dressed it with plaster of
wood-betony, and put me to bed, expressing to his sweetheart the
most vivid hopes of my recovery.
“These operations were scarcely finished when the maid’s two
brothers came home from their hiding-place; and it seems they
would have been there much sooner had not this gentleman given
them chase in the contrary direction. They, seeing the floor all
covered with blood, inquired the cause with wild trepidation of
manner. Their sister was the first to inform them of what had
happened, on which both the young men gripped to their weapons,
and the eldest, Samuel, cried out with the vehemence of a maniac,
‘Blessed be the righteous avenger of blood! Hoo! Is it then true that
the Lord hath delivered our greatest enemy into our hands!’ ‘Hold,
hold, dearest brother!’ cried the maid, spreading out her arms before
him. ‘Would you kill a helpless young man, lying in a state of
insensibility! What! although the Almighty hath put his life in your
hand, will He not require the blood of you, shed in such a base and
cowardly way?’
“‘Hold your peace, foolish girl,’ cried he, in the same furious strain.
‘I tell you, if he had a thousand lives I would sacrifice them all this
moment! Wo be to this old rusty and fizenless sword that did not
sever his head from his body when I had a fair chance in the open
field! Nevertheless he shall die; for you do not yet know that he hath,
within these few hours, murdered our father, whose blood is yet
warm around him on the bleak height.’
“‘Oh! merciful heaven! killed our father!’ screamed the girl, and
flinging herself down on the resting-chair, she fainted away. The two
brothers regarded not, but with their bared weapons made towards
the closet, intent on my blood, and both vowing I should die if I had a
thousand lives. The stranger interfered, and thrust himself into the
closet door before them, swearing that, before they committed so
cowardly a murder they should first make their way through his
body.
“Samuel retreated one step to have full sway for his weapon, and
the fury depicted on his countenance proved his determination. But
in a moment his gallant opponent closed with him, and holding up
his wrist with his left hand, he with the right bestowed on him a blow
with such energy that he fell flat on the floor among the soldier’s
blood. The youngest then ran on their antagonist with his sword and
wounded him, but the next moment he was lying beside his brother.
As soon as her brothers came fairly to their senses, the young woman
and her lover began and expostulated with them, at great length, on
the impropriety and unmanliness of the attempt, until they became
all of one mind, and the two brothers agreed to join in the defence of
the wounded gentleman, from all of their own party, until he was
rescued by his friends, which they did. But it was the maid’s simple
eloquence that finally prevailed with the fierce Covenanters.
“When my brothers came at last, with a number of my men, and
took me away, the only thing I remember seeing in the house was the
corpse of the old man whom I had shot, and the beautiful girl
standing weeping over the body; and certainly my heart smote me in
such a manner that I would not experience the same feeling again for
the highest of this world’s benefits. That comely young maiden, and
her brave intrepid lover, it would be the utmost ingratitude in me, or
in any of my family, ever to forget; for it is scarcely possible that a
man can ever be again in the same circumstances as I was, having
been preserved from death in the house of the man whom my hand
had just deprived of life.”
Just as he ended, the sick nurse peeped in, which she had done
several times before, and said, “Will your honour soon be
disengaged, d’ye think? for ye see because there’s a lass wanting till
speak till ye.”
“A lass, nurse? what lass can have any business with me? what is
she like?”
“Oo, ’deed, sir, the lass is weel enough for that part o’t, but she may
be nae better than she should be for a’ that; ye ken, I’se no answer for
that, for ye see because “like is an ill mark”; but she has been aften
up, speiring after ye, an’ gude troth she’s fairly in nettle-earnest now,
for she winna gang awa till she see your honour.”
The nurse being desired to show her in, a comely girl entered, with
a timid step, and seemed ready to faint with trepidation. She had a
mantle on, and a hood that covered much of her face. The privy
councillor spoke to her, desiring her to come forward and say her
errand, on which she said that “she only wanted a preevat word wi’
the captain, if he was that weel as to speak to ane,” He looked over
the bed, and desired her to say on, for that gentleman was his
brother, from whom he kept no secrets. After a hard struggle with
her diffidence, but, on the other hand, prompted by the urgency of
the case, she at last got out, “I’m unco glad to see you sae weel comed
round again, though I daresay ye’ll maybe no ken wha I am. But it
was me that nursed ye, an’ took care o’ ye in our house, when your
head was amaist cuttit off.”
There was not another word required to draw forth the most
ardent expressions of kindness from the two brothers, on which the
poor girl took courage, and, after several showers of tears, she said,
with many bitter sobs, “There’s a poor lad wha, in my humble
opinion, saved your life; an’ wha is just gaun to be hanged the day
after the morn. I wad unco fain beg your honour’s interest to get his
life spared.”
“Say not another word, my dear good girl,” said the councillor; “for
though I hardly know how I can intercede for a rebel who has taken
up arms against the government, yet, for your sake and his, my best
interest shall be exerted.”
“Oh, ye maun just say, sir, that the poor Whigs were driven to
desperation, and that this young man was misled by others in the
fervour and enthusiasm of youth. What else can ye say? But ye’re
good—oh, ye’re very good! and on my knees I beg that ye winna lose
ony time, for indeed there is nae time to lose!”
The councillor lifted her kindly by both hands, and desired her to
stay with his brother’s nurse till his return, on which he went away to
the president, and in half-an-hour returned with a respite for the
convict, John Lindsay, for three days, which he gave to the girl, along
with an order for her admittance to the prisoner. She thanked him
with the tears in her eyes, but added, “Oh, sir, will he and I then be
obliged to part for ever at the end of three days?”
“Keep up your heart, and encourage your lover,” said he, “and
meet me here again, on Thursday, at this same hour, for, till the
council meet, nothing further than this can be obtained.”
It may well be conceived how much the poor forlorn prisoner was
astonished when his own beloved Sally entered to him with a
reprieve in her hand, and how much his whole soul dilated when, on
the Thursday following, she presented him with a free pardon. They
were afterwards married, when the Gilmours took them under their
protection. Lindsay became a highly qualified surgeon, and the
descendants of this intrepid youth occupy respectable situations in
Edinburgh to the present day.
GRAYSTEEL:
A TRADITIONARY STORY OF CAITHNESS.
In a beautiful valley in the highlands of Caithness, lies embosomed

a small mountain tarn, called the Loch of Ranag. The hill of
Bencheildt, which ascends abruptly from the water’s edge, protects it
on the north. On the south it is overlooked by a chain of lofty
mountains, individually named Scarabine, Morven, and the Pap,
which form a natural barrier betwixt Sutherland and Caithness.
Morven, the highest in the range, is nearly two thousand feet above
the level of the sea, and turns up conspicuously over the
neighbouring summits, like a huge pyramid. The extensive wild lying
between this magnificent chain of hills and Ranag, is clothed in the
autumnal season with rich purple heather; and here the plover and
the grouse, the denizens of the solitary waste, live unmolested,
except by the murderous gun of the sportsman. Near the north edge
of the loch to which we have just alluded, there is a small island, on
which may be still seen the ruins of an old keep or castle. The last
proprietor of this fortalice is said to have been a noted freebooter of
the name of Graysteel, who kept the whole county in alarm by his
predatory incursions from the Ord to Duncansbay Head, and, like
Rob Roy and others of the same stamp, rigorously exacted “black
mail,” or protection money. Tradition also reports, that, besides
being possessed of great bodily strength, he was an expert
swordsman, and a person of such a jealous and tyrannical
disposition, that none durst venture to hunt or shoot on his grounds,
without being challenged to single combat; and it may be added, that
none whom he encountered trespassing in this way ever escaped
alive out of his hands. It happened that one of the family of Rollo,
while pursuing his sport in the direction, one day unfortunately
encroached on the sacred property of the robber. Being informed by
some of his retainers that a stranger was hunting on the west side of
the lake, Graysteel immediately sallied forth, and, running up
towards the sportsman with menacing looks and gestures, gave him
the accustomed challenge. Rollo saw he had no alternative but to give
him combat, and being a high-spirited young man, he instantly drew
his sword; and, although he defended himself for some time with
great skill and courage, it is needless to say that he sank at last,
mortally wounded, under the more powerful arm of his antagonist.
The ruffian afterwards stripped the dead body of every thing that was
of any value, and then threw it into the loch.
The account of this melancholy occurrence, as soon as it reached
the family and relatives of the unfortunate youth, plunged them into
the deepest distress; but none did it inspire with more poignant
regret than the young laird of Durie, who was his bosom friend, and
had just been affianced to his sister, a very beautiful and interesting
girl of sixteen. The moment he heard of Rollo’s tragical death, he
determined to avenge it, although he knew he had little chance of
surviving a personal encounter with such a desperado as Graysteel.
Accordingly, having furnished himself with a good Highland
broadsword, and without communicating his intention to any one, he
set off for the residence of the freebooter. Nor was the route he had
to take, any more than the occasion of the journey, agreeable. A
trackless moor, of some miles in extent, lay between him and Ranag,
so very bleak and barren, that, in the words of the poet,
The solitary bee
Flew there on restless wing,
Seeking in vain one blossom where to fix.
He had not gone far, however, when he was overtaken by a severe

storm, which rendered it impossible for him to continue his journey.
The wind, which blew at times with irresistible fury, dashed the rain
in his face, mingled with hail, and howled like a maniac on the naked
moor. Clouds of turbid vapour, issuing, as it were, from a vast
furnace, hurried across the sky; and now and then the rolling of
thunder, while it prognosticated a continuance of the storm, added
not a little to its terrors. Driven by the wind, and battered by the rain,
our traveller began anxiously to look around him for some place of
shelter. At length, to his great joy, he espied, a few hundred yards
distant, a small solitary cottage, situated on the edge of the moor.
Thither he immediately directed his steps, and, on entering, found its
sole occupant to be a poor aged widow, who lived upon the
gratuitous bounty of the public. There was something, however, in
her appearance, though bent down with years and infirmities, that
spoke of better days. On a small stool beside her lay the Bible, which
she seemed to have been just reading. She welcomed in the stranger
with a look of much cheerfulness, and kindly offered him such
accommodation for the night as her scanty means could afford. As
the storm continued to rage with unabated violence, Durie gladly
accepted the proffered hospitality; and, in the meantime, the
venerable hostess did all in her power to make him comfortable, by
putting an additional peat or two on the hearth, and furnishing him
with something to eat. On examining the scanty furniture of the
apartment, which was now more distinctly seen by the light of a
blazing turf-fire, he observed, in one corner, a very uncommon-
looking sword, with the appearance of which he was not a little
struck. The hilt and blade were covered over with a variety of strange
characters and fantastic devices, plainly indicating that it was of
foreign manufacture, and belonged to a remote period. His curiosity
was powerfully excited; and on asking the old woman how she came
by such a magnificent weapon, she gave him the following particulars
regarding it. The sword, which had originally belonged to a noble
Saracen, was that of her deceased husband, who had been a
volunteer in the regiment of Highlanders that had gone over to
Holland under the command of Lord Reay. He had received it as a
present from a Polish Jew, whose life he had saved in a moment of
extreme danger. She, moreover, informed him that her husband,
while on his deathbed, had strictly enjoined her not to sell or dispose
of it in any way, but to preserve it as an heirloom of the family. On
getting this account of the sword, Durie told the woman who he was,
and the errand on which he was going, and begged of her to give him
the use of it for a single day. After much entreaty, she at last agreed
to give it, on the condition that it should be strictly returned.
The storm, which was short-lived in proportion to its violence,
gradually died away towards morning; and at the first peep of dawn
our hero, who burned with impatience to measure weapons with the
murderer of his friend, was up, and, with his enchanted sword firmly
girt on his side, pursuing his solitary route across the moors. His
spirits were now buoyant with hope; and he beheld with a feeling of
sympathy the universal gladness which, after the late convulsion of
its elements, was diffused over the face of nature. Already the “bird
of the wilderness” sang blithely overhead, whilst the beams of a
brilliant morning sun were beginning to dissipate the mists which lay
thick and heavy upon the hills. Our traveller was not long in reaching
the brow of Benchieldt; and scarcely had he descended half way
down the side fronting the castle, when he was met by Graysteel,
who, as usual, challenged him for intruding on his grounds, and
desired him to draw and defend himself. “Villain!” cried Durie,
unsheathing his weapon, which flashed in his hand like the
Scandinavian monarch’s celebrated elfin sword—“villain! you
wantonly slew my friend, and you shall this day atone for it with your
heart’s blood!”
The robber chief laughed scornfully at what he considered an
empty bravado, and immediately made a thrust at his opponent,
which the latter parried off with admirable dexterity. A desperate
struggle now ensued. Graysteel fought with the fury of an enraged
mastiff; but young Durie pressed upon him so hard with his never-
failing blade, that he was obliged to give way, and at last received a
mortal wound. After this, the hero of our tale went immediately
home, and, having raised a body of stout followers, proceeded back
to Ranag, took the castle, and nearly levelled it with the ground.
The denouement of our little story may be anticipated. After a
decent period for mourning had elapsed, Durie led his beautiful
bride to the hymeneal altar. Nor, in the midst of his happiness, did
he forget his good friend, the old woman of the moor. The sword,
which had proved so invaluable an auxiliary to him in the hour of
need, he not only returned to her, but he took her under his
protection, and kept her comfortable for the rest of her days—
Joy seized her withered veins, and one bright gleam
Of setting life shone on her evening hours.
—John O’Groat Journal, 1836.

THE BILLETED SOLDIER.
In the autumn of 1803, the Forfar and Kincardine militia,—then an

infantry regiment of about 1000 strong,—en route from the south of
Scotland to Aberdeen, along the coast road, happened to perform the
march between the towns of Montrose and Bervie on a Saturday. The
want of the required accommodation in Bervie for so many men
rendered it necessary that a considerable portion should be billeted
in the adjoining villages of Johnshaven and Gourdon, and on farmers
and others on the line of march. In carrying out this arrangement, it
so happened that one private soldier was billeted on a farmer or
crofter of the name of Lyall, on the estate of East Mathers, situated
about a mile north-west of the village of Johnshaven. David Lyall,
gudeman of Gateside, was a douce, respectable individual, a worthy
member, if not an elder, of the secession church, Johnshaven. His
wife, Mrs Lyall, possessed many of the good qualities of her worthy
husband, whom she highly venerated, and pithily described as being
“as gude a man as ever lay at a woman’s side.” Mrs Lyall was a rigid
seceder, a strict Sabbatarian, stern and rigorous in everything
relating to the kirk and kirk affairs, deeply learned in polemical
disquisitions, had a wondrous “gift of gab,” and by no means allowed
the talent to lie idle in a napkin.
The soldier produced his billet, was kindly received, treated to the
best as regarded bed and board, was communicative, and entered
into all the news of the day with the worthy couple. Everything ran
smoothly on the evening of Saturday, and an agreeable intimacy
seemed to be established in the family; but the horror of Mrs Lyall
may be conceived, when, on looking out in the morning rather early,
she saw the soldier stripped to the shirt, switching, brushing, and
scrubbing his clothes on an eminence in front of the house.
“Get up, David Lyall,” she said, “get up; it ill sets you to be lying
there snoring, an’ that graceless pagan brackin’ the Lord’s day wi’ a’
his might, at oor door.”
David looked up, and quietly composing himself again, said, “The
articles of war, gudewife, the articles of war; puir chiel, he canna help
himsel—he maun do duty Sunday as well as Saturday.”
The soldier, after cleaning his clothes and taking a stroll in the
romantic dell of Denfenella adjoining, returned in time to breakfast,
which was a silent meal. With Mrs Lyall there was only “mony a sad
and sour look,” and on the table being cleared, she placed on it, or
rather thrust, the “big ha’ Bible” immediately in front of the soldier.
“Weel, mistress,” said the soldier, “what book is this?”
“That’s a beuk, lad,” said the gudewife, “that I muckle doubt that
you and the like o’ ye ken unco little about.”
“Perhaps,” was the reply; “we shall see.”
On opening the book the soldier said, “I have seen such a book
before.”
“Gin ye’ve seen sic a book before,” said Mrs Lyall, “let’s hear gin ye
can read ony.”
“I don’t mind though I do,” said the soldier, and taking the Bible
he read a chapter that had been marked by Mrs Lyall as one
condemnatory of his seeming disregard of the Sabbath. The reading
of the soldier was perfect.
“There, lad,” said David Lyall, “ye read like a minister.”
“An’ far better than mony ane o’ them,” said the mistress; “but gifts
are no graces,” she continued; “it’s nae the readin’ nor the hearin’
that maks a gude man—na, na, it’s the right and proper application—
the practice, that’s the real thing.”
David saw that “the mistress was aboot to mount her favourite
hobbyhorse,” and cut her lecture short by remarking that “it was
time to make ready for the kirk.”
“Aye, ye’ll gae to the kirk,” said Mrs Lyall, “an’ tak the sodger wi’
ye; and see that ye fesh the sermon hame atween ye, as I am no gaun
mysel the day.”
The soldier acquiesced, and on their way to church Mr Lyall
remarked, among other things, that “the gudewife was, if anything,

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Epilepsy The Intersection of

Neurosciences Biology Mathematics

On the Brink of Paradox Highlights from the

Recent Advances in Engineering Mathematics and Physics:

Nonlinear dynamics and chaos: with applications to

Systems of Nonlinear Partial Differential Equations

The Neurosciences and the Practice of Aviation Medicine

Quantum Mathematical Physics A Bridge between

Engineering Physics Rajendran

Fundamental Mathematics and Physics of Medical Imaging

© 2011 by Taylor and Francis Group, LLC

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© 2011 by Taylor and Francis Group, LLC

© 2011 by Taylor and Francis Group, LLC

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© 2011 by Taylor and Francis Group, LLC

© 2011 by Taylor and Francis Group, LLC

SECTiON I Foundations of Epilepsy

Chapter 1. Neuroanatomy as Applicable to Epilepsy: Gross and Microscopic

Chapter 2. Introduction to EEG for Nonepileptologists Working in Seizure Prediction

Chapter 3. Basic Mechanisms of Seizure Generation................................................................... 41

Chapter 4. An Introduction to Epileptiform Activities and Seizure Patterns Obtained by

Chapter 5. Seizures and Epilepsy: An Overview.......................................................................... 65

SECTiON II Foundations of Engineering, Math, and Physics

Chapter 6. Intracranial EEG: Electrodes, Filtering, Amplification, Digitization,

Chapter 7. Time-Frequency Energy Analysis............................................................................... 95

Chapter 8. Neurodynamics and Ion Channels: A Tutorial.......................................................... 111

© 2011 by Taylor and Francis Group, LLC

Chapter 9. Nonlinear Time Series Analysis in a Nutshell.......................................................... 125

Chapter 10. How to Detect and Quantify Epileptic Seizures....................................................... 139

SECTiON III The Challenge of Prediction

Chapter 13. Prediction..................................................................................................................203

SECTiON IV The State of Seizure Prediction:

Chapter 15. Seizure Prediction: An Approach Using Probabilistic Forecasting.......................... 249

Chapter 17. Preictal Directed Interactions in Epileptic Brain Networks..................................... 265

Chapter 18. Seizure Prediction and Observability of EEG Sources............................................. 273

© 2011 by Taylor and Francis Group, LLC

Chapter 21. Time-Series-Based Real-Time Seizure Prediction................................................... 321

Chapter 22. Optimizing Seizure Detection Algorithms toward the Development of

Chapter 23. Initiation and Termination of Seizure-Like Activity in Small-World

SECTiON V The State of Seizure Prediction: Seizure Generation

Chapter 26. Microanalysis and Macroanalysis of High-Frequency Oscillations in the

SECTiON VI The State of Seizure Prediction: Seizure Control

Chapter 27. Vagus Nerve Stimulation Triggered by Machine Learning–Based Seizure

Chapter 28. Low-Frequency Stimulation as a Therapy for Epilepsy............................................ 397

© 2011 by Taylor and Francis Group, LLC

SECTiON VII The State of Seizure Prediction: Technology

Chapter 30. EPILAB: A MATLAB® Platform for Multifeature and Multialgorithm

Chapter 31. Emerging Technologies for Brain-Implantable Devices........................................... 429

SECTiON VIII Nocturnal Frontal Lobe Epilepsy: A Paradigm

Chapter 33. Nicotinic Acetylcholine Receptors in Circuit Excitability and Epilepsy:

Chapter 34. Channelopathies in Epileptology.............................................................................. 461

Chapter 36. How to Measure Circadian Rhythmicity in Humans................................................ 477

Chapter 37. Seizure Prediction and the Circadian Rhythm......................................................... 489

© 2011 by Taylor and Francis Group, LLC

* See Acknowledgments for a complete list of sponsors.

© 2011 by Taylor and Francis Group, LLC

SECTiON IV The State of Seizure Prediction:

SECTiON VIII Nocturnal Frontal Lobe Epilepsy: A Paradigm