SUMMARY
Some basic physiological mechanisms which may be involved in epileptic disturbances of brain function have been reviewed with particular reference to temporal lobe automatisms (psychomotor or psychoparetic seizures).
Microelectrode studies of the firing patterns of individual neurones, and changes in membrane potential in neurones whose activity has been recorded with intracellular microélectrodes has shown that inactivation by prolonged depolarization, and arrest of discharge by prolonged inhibition are as important as excitatory events in epileptic discharge. Profound alterations in the behaviour of single cells may occur without evidence of high‐voltage electrical activity in the usual EEG. Emphasis is placed upon changes in patterns of discharge in response to incoming sensory information which must cause important distortions in information processing by the brain, even during periods between gross overt clinical attacks.
Amnesia and irrelevant automatic behaviour does not follow after‐discharge in amygdaloid and hippocampal structures in man unless epileptic activity spreads to affect brain stem structures, and unless there is significant change in neo‐cortical function. The “activation” pattern which characterizes the EEG over temporal and other cortical regions at the onset of such attacks is associated with striking changes in unitary activity in the temporal neo‐cortex of both hemispheres. It is concluded that it is the epileptic “activation paralysis” of limbic and brain stem circuits essential to the consolidation of memories in neo‐cortex which are necessarily involved in the typical temporal lobe automatism with amnesia.
The importance of William Lennox's views on the neurochemical mechanisms involved in seizures is stressed, particularly in view of the growing evidence that chemical mechanisms are involved in the storage of memory, and certainly in excitatory and inhibitory processes of epileptic discharge. The rapid growth of knowledge in the field of genetically determined metabolic defects, as well as rapid technical advances in neurochemistry, should make it possible to advance our knowledge of the chemistry of seizures much more rapidly than it has been possible in the past. It was suggested that this might be an appropriate major concern of the American Epilepsy Society, as a tribute to William G. Lennox, its founder.
RÉSUMÉ
Des mécanismes basaux physiologiques pouvant être impliqués dans des troubles épileptiques de la fonction cérébrale ont été, en particulier, considered quant aux automatismes du lobe temporal (crises psychomotrices ou psychoparésiques).
Des études microélectrodiques des “firing patterns” de neurones individuels et des changements du potentiel membraneux dans des neurones dont l'activité a été enregistrée avec des microélectrodes intracellulaires ont montré que l'inactivation par la dépolarisation prolongée, et arrêt de la décharge par l'inhibition prolongée sont aussi importants que des événements excitatoires dans la décharge épileptique. De profondes altérations...