Departments of Neurology, Neurobiology, and Neurosurgery, Yale University School of Medicine, New Haven, CT 06520, USA.
Lancet Neurol. 2012 Sep;11(9):814-26. doi: 10.1016/S1474-4422(12)70188-6.
Consciousness is essential to normal human life. In epileptic seizures consciousness is often transiently lost, which makes it impossible for the individual to experience or respond. These effects have huge consequences for safety, productivity, emotional health, and quality of life. To prevent impaired consciousness in epilepsy, it is necessary to understand the mechanisms that lead to brain dysfunction during seizures. Normally the consciousness system-a specialised set of cortical-subcortical structures-maintains alertness, attention, and awareness. Advances in neuroimaging, electrophysiology, and prospective behavioural testing have shed light on how epileptic seizures disrupt the consciousness system. Diverse seizure types, including absence, generalised tonic-clonic, and complex partial seizures, converge on the same set of anatomical structures through different mechanisms to disrupt consciousness. Understanding of these mechanisms could lead to improved treatment strategies to prevent impairment of consciousness and improve the quality of life of people with epilepsy.
意识是人类正常生命活动的必要条件。在癫痫发作期间，意识通常会短暂丧失，使个体无法体验或做出反应。这些影响对安全、生产力、情绪健康和生活质量都有巨大的影响。为了防止癫痫发作时意识受损，有必要了解导致癫痫发作期间大脑功能障碍的机制。通常情况下，意识系统——一组专门的皮质下结构——维持警觉、注意力和意识。神经影像学、电生理学和前瞻性行为测试的进展揭示了癫痫发作如何扰乱意识系统。不同类型的癫痫发作，包括失神、全面强直阵挛和复杂部分性发作，通过不同的机制汇聚到同一组解剖结构，以扰乱意识。对这些机制的理解可能会导致改进治疗策略，以防止意识障碍，并提高癫痫患者的生活质量。
