Marmara University, School of Medicine, Department of Pharmacology, Istanbul, Turkey.
Epilepsy Res. 2013 Feb;103(2-3):111-23. doi: 10.1016/j.eplepsyres.2012.08.008. Epub 2012 Sep 16.
Typical and atypical seizures of absence epilepsy are thought to be generated by a rhythmogenic interplay between the cortex and the thalamus. However, the question remains as to which other subcortical and extrathalamic structures are involved in the pathophysiology of typical and atypical absence epilepsy. Limbic structures are not thought to be involved in typical absence seizures, since in animal models and human patients there is no evidence for the occurrence of spike-and-wave discharges of absence seizures in the limbic regions. However, there are a number of observations from animal models of absence epilepsy that point to a possibly important link between absence seizure mechanisms and limbic structures. Atypical absence seizures are distinct in many ways from typical absence seizures although they bear considerable clinical, EEG, and pharmacological resemblance to typical absence seizures. The differences between typical and atypical seizures of absence epilepsy appear to be circuitry dependent. While both typical and atypical absence seizures involve the cortico-thalamo-cortical circuitry, they each engage different neuronal networks within that circuitry. This review examines the involvement of limbic structures in typical and atypical absence seizures, shows that limbic circuitry forms an integral component of the absence epilepsy network and concludes that further knowledge of this component is important for understanding the complex relationships involved in absence epilepsy.
失神癫痫的典型和非典型发作被认为是由皮层和丘脑之间的节律产生相互作用引起的。然而，目前仍不清楚哪些其他皮质下和皮质外结构参与了典型和非典型失神癫痫的病理生理学。边缘结构被认为不参与典型失神发作，因为在动物模型和人类患者中，没有证据表明在边缘区域出现失神发作的棘波和尖波放电。然而，从失神癫痫的动物模型中有许多观察结果表明，失神发作机制与边缘结构之间可能存在重要联系。非典型失神发作在许多方面与典型失神发作不同，尽管它们在临床、脑电图和药理学方面与典型失神发作有很大的相似性。典型和非典型失神发作之间的差异似乎依赖于电路。虽然典型和非典型失神发作都涉及皮质-丘脑-皮质回路，但它们在该回路中涉及不同的神经元网络。这篇综述检查了边缘结构在典型和非典型失神发作中的参与情况，表明边缘回路是失神癫痫网络的一个组成部分，并得出结论，进一步了解这一组成部分对于理解失神癫痫中涉及的复杂关系很重要。
