Niedermeyer E
Clin Electroencephalogr. 1981 Oct;12(4):177-91. doi: 10.1177/155005948101200404.
Abnormal arousal responses paired with paroxysmal discharges and photosensitivity are the principal mechanisms in the precipitation of seizures in primary generalized epilepsy. The abnormal arousal responses show a consistent maximum over the frontal midline region. An exception from this rule was found in two children with primary generalized epilepsy (petit mal absences, one also with grand mal) with a strongly positive family history. In these patients, the generalized-synchronous bursts showed a maximum over the vertex (Cz electrode). Both of these children also had single spikes over the Rolandic region. A relationship between primary generalized and benign Rolandic epilepsy is demonstrated. Both forms of seizure disorder are based on dysfunction (hyperexcitability) rather than on a structural epileptogenic lesion. A dichotomy of dysfunctional and structural epilepsies is presented but gray zones of overlap indubitably exist. The limitations of the dichotomy concept are pointed out.
异常觉醒反应与阵发性放电及光敏性相结合是原发性全身性癫痫发作诱发的主要机制。异常觉醒反应在额中线区域表现出一致的最大值。在两名有强烈家族史的原发性全身性癫痫患儿（失神小发作，其中一名还伴有大发作）中发现了该规律的一个例外。在这些患者中，全身性同步爆发在头顶（Cz电极）表现出最大值。这两名儿童在中央沟区域也都有单个棘波。原发性全身性癫痫与良性中央沟癫痫之间的关系得到了证实。两种癫痫发作形式均基于功能障碍（兴奋性过高）而非结构性致痫病变。本文提出了功能性癫痫和结构性癫痫的二分法，但无疑存在重叠的灰色地带。同时指出了二分法概念的局限性。
