Department of Neuropsychiatry, University of Birmingham and BSMHFT, Birmingham, UK.
Behav Neurol. 2011;24(1):3-10. doi: 10.3233/BEN-2011-0311.
Alterations in consciousness are central to epileptic manifestations, and involve changes in both the level of awareness and subjective content of consciousness. Generalised seizures are characterised by minimal responsiveness and subjective experience whereas simple and complex partial seizures demonstrate more selective disturbances. Despite variations in ictal origin, behaviour and electrophysiology, the individual seizure types share common neuroanatomical foundations generating impaired consciousness. This article provides a description of the phenomenology of ictal consciousness and reviews the underlying shared neural network, dubbed the 'consciousness system', which overlaps with the 'default mode' network. In addition, clinical and experimental models for the study of the brain correlates of ictal alterations of consciousness are discussed. It is argued that further investigation into both human and animal models will permit greater understanding of brain mechanisms and associated behavioural consequences, possibly leading to the development of new targeted treatments.
意识改变是癫痫发作的核心表现，涉及意识水平和意识主观内容的变化。全面性发作的特点是反应迟钝和主观体验较少，而简单和复杂部分性发作则表现出更选择性的障碍。尽管发作起源、行为和电生理学有所不同，但各种类型的癫痫发作都有共同的神经解剖学基础，导致意识障碍。本文描述了癫痫发作时意识的现象学，并回顾了潜在的共享神经网络，称为“意识系统”，该系统与“默认模式网络”重叠。此外，还讨论了研究癫痫发作时意识改变的脑相关因素的临床和实验模型。有人认为，对人类和动物模型的进一步研究将使我们更好地了解大脑机制和相关的行为后果，可能导致新的有针对性的治疗方法的开发。
