Arousal and Consciousness in Focal Seizures

Epilepsy Curr. 2021 Oct 24;21(5):353-359. doi: 10.1177/15357597211029507. eCollection 2021 Oct.ABSTRACTImpaired consciousness during seizures severely affects quality of life for people with epilepsy but the mechanisms are just beginning to be understood. Consciousness is thought to involve large-scale brain networks, so it is puzzling that focal seizures often impair consciousness. Recent work investigating focal temporal lobe or limbic seizures in human patients and experimental animal models suggests that impaired consciousness is caused by active inhibition of subcortical arousal mechanisms. Focal limbic seizures exhibit decreased neuronal firing in brainstem, basal forebrain, and thalamic arousal networks, and cortical arousal can be restored when subcortical arousal circuits are stimulated during seizures. These findings open the possibility of restoring arousal and consciousness therapeutically during and following seizures by thalamic neurostimulation. When seizures cannot be stopped by existing treatments, targeted subcortical stimulation may improve arousal and consciousness, leading to improved safety and better psychosocial function for people with epilepsy.PMID:34924835 | PMC:PMC8655266 | DOI:10.1177/15357597211029507

Source: Epilepsy Curr - December 20, 2021 Category: Neurology Authors: Hal Blumenfeld Source Type: research