SUMMARY
A study was carried out on two cases of reflex epilepsy with hemiconvulsive seizures induced by proprioceptive stimulations (tuning fork vibrations and active and/or passive movements).
A proprioceptive dissociation is shown to exist in reflex epilepsy, i.e. the seizures are induced only by certain proprioceptive stimuli (vibration or movement).
It is assumed that the proprioceptive stimuli generated during the convulsive seizure intervene by a feedback mechanism. By means of this feedback mechanism the afferent proprioceptive impulses in the course of the seizure facilitate the cortical mechanisms of clonic transformation of the convulsive fit. Interruption of this mechanism in the clonic phase of the paroxysm by immobilization of the parts showing myoclonic jerks brought about immediate arrest of the seizure in the first case and temporary disappearance of the spontaneous focal discharges during the seizure in the second case.
RÉSUMÉ
Les auteurs présentent deux cas d'épilepsie réflexe avec des crises hémiconvulsives provoquées par des stimulations proprioceptives (les vibrations d'un diapason et les mouvements passifs ou actifs).
On a observé une dissociation proprioceptive au cours des crises, provoquées seulement par certaines stimulations proprioceptives (vibrations ou mouvements).
On suppose que les stimulations proprioceptives apparaissant au cours des crises interviennent par un mécanisme de feedback. Par ce mécanisme les impulsions afférentes proprioceptives interviennent au niveau cortical, facilitant la transformation clonique des crises convulsives. L'interruption de ces mécanismes dans sa phase clonique par l'immobilisation du segment animé de mouvements myocloniques a provoqué un arrêt immédiat de la crise dans notre premier cas et une disparition de courte durée des décharges focales spontanées dans notre deuxième cas.
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