Pathophysiology of altered consciousness during seizures

Lee, K. H.; Meador, Kimford J.; Park, Yong D.; King, Don W.; Murro, Anthony M.; Pillai, Jay J.; Kaminski, Robert J.

doi:10.1212/wnl.59.6.841

Cited by 93 publications

(63 citation statements)

References 20 publications

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“…Pronounced slowing in bilateral frontal and parietal association cortices in patients undergoing complex partial temporal lobe seizures is further evidenced by intracranial EEG recordings taken of these patients [12]. Such findings support the hypothesis that loss of consciousness during temporal lobe seizures may result from focal seizures arising in the medial temporal lobe spreading to midline subcortical structures (upper brainstem -diencephalic activating systems), disrupting their activating function, and thus secondarily leading to widespread inhibition of the frontoparietal cortex [53,61].…”

Section: Epileptic Seizuressupporting

confidence: 67%

Consciousness: A Neurological Perspective

Cavanna

Shah

Eddy

et al. 2011

Behavioural Neurology

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Abstract. Consciousness is a state so essentially entwined with human experience, yet so difficult to conceptually define and measure. In this article, we explore how a bidimensional model of consciousness involving both level of arousal and subjective awareness of the contents of consciousness can be used to differentiate a range of healthy and altered conscious states. These include the different sleep stages of healthy individuals and the altered states of consciousness associated with neurological conditions such as epilepsy, vegetative state and coma. In particular, we discuss how arousal and awareness are positively correlated in normal physiological states with the exception of REM sleep, while a disturbance in this relationship is characteristic of vegetative state, minimally conscious state, complex partial seizures and sleepwalking.

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Section: Epileptic Seizuressupporting

confidence: 67%

Consciousness: A Neurological Perspective

Cavanna

Shah

Eddy

et al. 2011

Behavioural Neurology

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“…In general, clinical studies rely on indirect criteria for the measure of consciousness. More recent studies have proposed 2 to 4 criteria to estimate consciousness during seizures [6,7,29,31]. Recently we proposed a 8 criteria scale in order to capture the different elements for a more objective evaluation of the AOC during seizures (Table 1) [1].…”

Section: No Visual Attention (0 or 1)mentioning

confidence: 99%

“…Metabolic neuroimaging studies using ictal SPECT in order to study the increase of cerebral blood flow (CBF) in regions affected by seizures have suggested that secondary involvement of thalamus and/or subcortical structures during seizures plays a determinant role in the impairment of consciousness [6,29].…”

Section: No Visual Attention (0 or 1)mentioning

confidence: 99%

The Global Workspace (GW) Theory of Consciousness and Epilepsy

Bartolomei

Naccache

2011

Behavioural Neurology

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Abstract. The global workspace (GW) theory proposes that conscious processing results from coherent neuronal activity between widely distributed brain regions, with fronto-parietal associative cortices as key elements. In this model, transition between conscious and non conscious states are predicted to be caused by abrupt non-linear massive changes of the level of coherence within this distributed neural space. Epileptic seizures offer a unique model to explore the validity of this central hypothesis. Seizures are often characterized by the occurrence of brutal alterations of consciousness (AOC) which are largely negatively impacting patients' lives. Recently, we have shown that these sudden AOC are contemporary to non-linear increases of neural synchrony within distant cortico-cortical and cortico-thalamic networks. We interpreted these results in the light of GW theory, and suggested that excessive synchrony could prevent this distributed network to reach the minimal level of differentiation and complexity necessary to the coding of conscious representations. These observations both confirm some predictions of the GW model, and further specify the physiological window of neural coherence (minimum and maximum) associated with conscious processing.

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“…LEV-induced suicidal behavior has been reported infrequently with a past history of affective disorders [4][5][6][7]. The authors report an apparent dose/concentration-dependent LEV-induced de novo major depression with near fatal suicide attempt in a patient without prior history of affective disorder.…”

Section: Short Communicationmentioning

confidence: 91%

Iatrogenic depression with Antiepileptic Drug Therapy in Patients with Partial Seizures

El-Dine¹

2015

J Depress Anxiety

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Pathophysiology of altered consciousness during seizures

Cited by 93 publications

References 20 publications

Consciousness: A Neurological Perspective

Consciousness: A Neurological Perspective

The Global Workspace (GW) Theory of Consciousness and Epilepsy

Iatrogenic depression with Antiepileptic Drug Therapy in Patients with Partial Seizures

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