The Application of the Reflex Theory in the Interpretation of the Clinical Picture, Genesis, and Treatment of Epilepsy

Servít, Z

doi:10.1111/j.1528-1157.1962.tb06162.x

Cited by 21 publications

(8 citation statements)

References 25 publications

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“…Self-stimulation by tactile or proprioceptive inputs has been documented in patients with seizures arising from trigeminal and upper extremity somatosensory regions [5], those with infantile spasms who induced spasms by tapping on the chin, flexion and external rotation of the leg with dislocation of the femur, and particular posturing of the body followed by rhythmic shaking of the head [2], and a patient with post-traumatic epilepsy who provoked seizures by sequential motor and sensory stimulation [3]. Children with severe psychomotor delay often exhibit repetitive purposeless behaviors, and incidentally they may discover that the behavior induces seizures [2].…”

Section: Discussionmentioning

confidence: 99%

“…B: Interictal EEG during sleep shows spikes on Fp2, and bilateral synchronous slow spike and waves with maximum amplitudes on O1 and O2. C: On ictal EEG, ictal discharge is not found during stimulation of right eyebrow (1), while right arm flexion and left arm extension, head nodding(2), and head deviation to the right (3) are accompanied by ictal activities of bilateral occipital sharp waves (4) followed by desynchronization for several seconds(5).…”

mentioning

confidence: 99%

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Self-induced seizures presumably by peri-orbital somatosensory self-stimulation: A report of two cases

Takayama¹,

Takahashi²,

Mogami³

et al. 2012

Brain and Development

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Self-induced seizures presumably by peri-orbital somatosensory self-stimulation: A report of two cases

Takayama¹,

Takahashi²,

Mogami³

et al. 2012

Brain and Development

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“…The uniformity of the factors which induce the attacks and of their effects, both in the present patient and in subjects with tonic seizures only, enabled us to assume a reflex (in a broad sense) mechanism of the seizures (7,15,16,18). Stretched muscles may provide a sensory stimulus giving rise to afferent impulses; the possible part played by the activity of cortical and subcortical centres, closely associated with the initiation of an abrupt voluntary movement (10) should also be taken into consideration.…”

Section: Discussionmentioning

confidence: 99%

Unusual Case of Epilepsy with Akinetic and Tonic Seizures induced by Movement

Dowzenko¹,

Zielinski²

1966

Epilepsia

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CASE REPORTA case of an extremely rare form of reflex epilepsy is patient H.C., 22 years old, female, born at full term; delivery was normal. Her development has been normal. She has had no severe disease or head injury in her history; and started to menstruate at the age of 15. At age 16 she had two typical grand ma1 seizures with tongue biting. Since the age of 18 years she has been suffering from attacks of a sudden weakening of the extremities occurring always at the initial phase of any kind of rapid locomotor movement, particularly when following rest. Arising rapidly from a chair, starting suddenly to walk or to dance, or even abruptly increasing the pace of movement may induce the attack. With the onset of the seizure the patient has an ill-defined sensation, lasting only a fraction of a second, described as a feeling of stiffness or tension at first in one leg and then extending to one side of the body. This is followed by the weakness of the extremities of the same side. The leg becomes powerless as if it were of "cotton wool" or "sponge"; the upper extremity becomes limp. Sometimes the seizure is more severe, irivolving one upper and both lower extremities and causing a fall which is not abrupt since the weakness develops gradually. The weakness quickly disappears and then the patient is able to stand up and continue her .walk. The duration of the whole attack does not exceed several seconds. If the attack is less severe the patient does not fall, but leans toward the opposite, uninvolved side. The abortive form of the attack consists only of the feeling of "spasm" in one leg. Both sides of the body may be alternately involved, although seizures of the right side are more frequent, and the patient is not able to tell what it depends on.She has never lost consciousness nor hurt herself when falling. She has usually up to a dozen fits daily; initially they were less frequent. They occur more often before the menstrual period and also if the patient fails to take her anticonvulsive drugs.Movement of gradually inc:easing speed is not likely to induce the seizure; emotional stimuli, even very intense ones never provoke them.At the ward, several seizures were observed which were induced by the patient's rising rapidly from a chair on order, and their appearance was in accordance with the description given above. 7 (1 966) 233-237 Epilepsia,

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“…Three conditions have been considered necessary for a paroxysmal response to an otherwise innocuous stimulus: the epileptic focus, epileptic susceptibility, and the epileptogenic stimulus (Servit 1963). Epileptic susceptibility may be operationally defined using models of experimental epilepsy.…”

Section: Discussionmentioning

confidence: 99%

“…For example, systemic metrazol (pentylenetetrazol) is a pharmacologic means to increase epileptic susceptibility. It allows a previously quiescent experimental focus to activate a focal seizure which often secondarily generalizes (Servit 1963). In this example, a systemic alteration in neuronal excitability has been a prerequisite for an otherwise innocuous stimulus to become epileptogenic.…”

Section: Discussionmentioning

confidence: 99%

Mechanisms of Epileptic Susceptibility to Photic Activation Case Study of the Photoconvulsive Response

1969

Epilepsia

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SUMMARY A study of the photoconvulsive response to photic activation in a single subject was undertaken using the methods of generalized harmonic analysis. This paper presents such methods and the preliminary results of their application to the problem of defining the mechanisms of moment to moment variation in susceptibility to epileptic activation by intermittent photic stimulation. The EEG was divided into the following contiguous blocks of time: (1) a steady state period; (2) the first trial of photic activation, i.e., without a paroxysmal response; (3) a second trial of activation which did provoke a paroxysmal response; and (4) a non‐contiguous post‐paroxysmal trial of photic stimulation which was not associated with a photoconvulsive response. Spectral analysis of the first trial revealed that this period differed from the steady state by increased per cent power and coherence in the δ‐range and decreased percent power and coherence in the α‐range. These changes were found to be qualitatively similar to those seen in photoconvulsive response to the second trial. It was suggested that the first trial of activation served to partially activate the same seizure processes which were to appear in the photoconvulsive response. A later failure to obtain the photoconvulsive response was found to be coincident with lack of the above partial activation. These findings are discussed in the framework of the reflex theory of stimulus dependent epilepsies. RÉSUMÉ Avec la méthode d'analyse harmonique globale, on a étudié, chez un sujet, la réponse photoconvulsive. Ce travail présente les premiers résultats obtenus par ces méthodes appliquées à l'étude de la définition des mécanismes impliqués, à chaque instant, dans les variations de la susceptibilitéà l'activation photoconvulsive. L'EEG a été ainsi divisé en périodes de temps successives: (1) une période de repos; (2) le premier essai d'activation photique sans période paroxystique; (3) un second essai d'activation provoquant une période paroxystique. Ensuite (4) on a fait un autre essai espacé dans le temps par rapport aux précédents, dans lequel la stimulation lumineuse intermittente ne provoquait pas de réponse convulsive. L'analyse spectrale du premier essai a démontré que cette période était différente de la période de repos du fait de Faugmentation du pourcentage en énergie et en cohérence de l'activité de la bande delta et du fait de la diminution du pourcentage en énergie et cohérence de la bande alpha. Ces changements étaient qualitativement semblables à ceux observés dans la réponse photoconvulsive du second essai. On a ainsi pensé que la première partie de l'activation servait à activer partiellement les mêmes processus paroxystiques qui apparaissaient ensuite dans la réponse photoconvulsive. Lorsqu'il n'y avait pas la réponse photoconvulsive, de même on ne retrouvait pas les signes d'activation partielle précédemment décrits. Les résultats sont discutés dans le cadre de la théorie réflexe des épilepsies déclenchees par des stimuli.

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The Application of the Reflex Theory in the Interpretation of the Clinical Picture, Genesis, and Treatment of Epilepsy

Cited by 21 publications

References 25 publications

Self-induced seizures presumably by peri-orbital somatosensory self-stimulation: A report of two cases

Self-induced seizures presumably by peri-orbital somatosensory self-stimulation: A report of two cases

Unusual Case of Epilepsy with Akinetic and Tonic Seizures induced by Movement

Mechanisms of Epileptic Susceptibility to Photic Activation Case Study of the Photoconvulsive Response

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