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2009 ; 1157
(ä): 48-60
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Theories of impaired consciousness in epilepsy
#MMPMID19351355
Yu L
; Blumenfeld H
Ann N Y Acad Sci
2009[Mar]; 1157
(ä): 48-60
PMID19351355
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Although the precise mechanisms for control of consciousness are not fully
understood, emerging data show that conscious information processing depends on
the activation of certain networks in the brain and that the impairment of
consciousness is related to abnormal activity in these systems. Epilepsy can lead
to transient impairment of consciousness, providing a window into the mechanisms
necessary for normal consciousness. Thus, despite differences in behavioral
manifestations, cause, and electrophysiology, generalized tonic-clonic, absence,
and partial seizures engage similar anatomical structures and pathways. We review
prior concepts of impaired consciousness in epilepsy, focusing especially on
temporal lobe complex partial seizures, which are a common and debilitating form
of epileptic unconsciousness. We discuss a "network inhibition hypothesis" in
which focal temporal lobe seizure activity disrupts normal cortical-subcortical
interactions, leading to depressed neocortical function and impaired
consciousness. This review of the major prior theories of impaired consciousness
in epilepsy allows us to put more recent data into context and to reach a better
understanding of the mechanisms important for normal consciousness.
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