Yamauchi T
Department of Neuropsychiatry, Saitama Medical School, Trumagun, Japan.
Epilepsia. 1998;39 Suppl 5:16-20. doi: 10.1111/j.1528-1157.1998.tb05144.x.
Two neuronal structures, i.e., the cerebral cortex and the subcortical structures, were shown by clinical observations to be involved in maintaining consciousness. The alteration of consciousness during epileptic seizures is discussed with respect to these findings: Alterations of consciousness during epileptic seizures may be produced by subcortical, i.e., reticular formation, and/or cortical dysfunction followed by excessive, hypersynchronous neuronal discharges. An impairment of consciousness during absence seizures may be due mainly to cortical dysfunction; during complex partial seizures (CPS), it may be due to dysfunctional subcortical neuronal structures. The mechanisms underlying an alteration of consciousness are defined as causing "irritative" functional disturbances and/or as having "inhibitory" effects on consciousness-related structures.
临床观察表明，有两种神经结构，即大脑皮层和皮层下结构，参与维持意识。结合这些发现讨论癫痫发作期间意识的改变：癫痫发作期间的意识改变可能由皮层下结构，即网状结构，和/或皮层功能障碍引起，随后出现过度、超同步的神经元放电。失神发作期间的意识障碍可能主要归因于皮层功能障碍；在复杂部分性发作（CPS）期间，可能归因于皮层下神经元结构功能失调。意识改变的潜在机制被定义为引起“刺激性”功能障碍和/或对意识相关结构产生“抑制性”作用。
