Chauvel P, Lamarche M
Neurochirurgie. 1975 Mar-Apr;21(2):121-37.
Several observations in Man as well as in animals have stressed the importance of specific afferents in triggering some focal cortical fits. The authors report an analysis of the role of various afferents on the activity of a precentral focus in the monkey. The chronic focus was created on one adult female monkey by subpial injection of alumina cream in the motor area of the left foot. Typical seizures were clonic and local. The most striking feature was that movement or, more generally, proprioceptive afferents from the concerned leg could elicit and maintain these motor fits. This assumption was verified by curaryzing the animal with succinyl-choline. In this condition, the number of attacks was strongly reduced. Since there was no lowering of excitability at the central level, as shown by direct stimulation of the perifocal area, this decrease seems to result from the lack of triggering mechanisms. If this is the case, one should be able to elicit seizures by proprioceptive afferent volleys coming from the concerned leg. In fact, although passive motion was not very effective (the reason probably being the decrease of the back-ground activity of stretch receptors under curare), direct electrical intramuscular stimulation was always followed by an attack. Similar stimulation of the opposite leg was ineffective. These results are discussed. The role of the "motor cortex proprioceptive feedback" in jacksonian progression of motor seizures is debated. The same concept is applied to "startle epilepsy", for which a physiological hypothesis is purposed.
对人类和动物的多项观察都强调了特定传入神经在引发某些局灶性皮质癫痫发作中的重要性。作者报告了对各种传入神经在猴子中央前回病灶活动中所起作用的分析。通过在一只成年雌性猴子的左脚运动区软膜下注射氧化铝乳剂,制造了慢性病灶。典型的癫痫发作是阵挛性的且局限于局部。最显著的特征是来自相关腿部的运动或更普遍的本体感觉传入神经能够引发并维持这些运动性癫痫发作。通过用琥珀酰胆碱使动物箭毒化验证了这一假设。在这种情况下,发作次数大幅减少。由于如对病灶周围区域的直接刺激所示,中枢水平的兴奋性没有降低,这种减少似乎是由于触发机制的缺乏。如果是这样的话,应该能够通过来自相关腿部的本体感觉传入神经冲动引发癫痫发作。事实上,尽管被动运动效果不太好(原因可能是箭毒作用下牵张感受器的背景活动降低),但直接的肌肉内电刺激总是会引发一次发作。对另一条腿进行类似刺激则无效。对这些结果进行了讨论。探讨了“运动皮质本体感觉反馈”在杰克逊运动性癫痫进展中的作用。同样的概念也应用于“惊吓性癫痫”,并提出了一个生理学假设。