Focal to bilateral tonic-clonic seizures (FBTCS) are a feature of focal epilepsy, characterised by seizures that spread contralaterally to the origin of ictal discharge. Widespread global network disruption has been shown in patients with FBTCS compared to those with focal epilepsy. A structure-function relationship has been proposed, suggesting the role of the underlying subcortical structures in network alterations. Disease duration has been associated with whole-brain network disruption. Global network disruption may be a subtle marker in differentiating the likelihood of developing FBTCS, allowing treatment to be tailored.
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