Concepts of Brain Oxygen Sufficiency During Seizures
To resolve conflicting evidence of oxygen sufficiency or insufficiency during seizures, signals of metabolic and circulatory function were monitored in rat cerebral cortex during recurrent seizures. Early seizures were accompanied by increased blood volume, increased tPO2, and oxidative shifts of cytochrome a,a3, indicative of oxygen sufficiency. Later seizures were accompanied by a smaller increment in blood volume, a fall in tPO2, and shifts toward reduction of cytochrome a,a3, suggesting that cerebral oxygen supply became insufficient to meet demand. Responses suggesting oxygen insufficiency occurred during short duration ictal bursts, interictal spikes or electrocortical stimulation at times when longer duration ictal episodes still were accompanied by responses signalling oxygen sufficiency. These data indicate that there is a progressive dissociation of the normally tight couple between neuronal activity, energy demand, and cerebral blood flow during status epilepticus. Systemic derrangements that often accompanied recurrent seizures also contributed to decreased cerebral oxygenation. These factors may cause the neuronal damage reported to follow prolonged status epilepticus.
KeywordsStatus Epilepticus Cerebral Oxygenation Recurrent Seizure Systemic Arterial Blood Pressure Direct Cortical Stimulation
Unable to display preview. Download preview PDF.
- Chance, B. and Williams, G. R., 1956, The respiratory chain and oxidative phosphorylation, Adv. Enzymol., 17:65–134.Google Scholar
- Ingvar, D. H. and Schwartz, M. S., 1974, Blood flow patterns induced in the dominant hemisphere by speech and reading, Brain, 96:274–288.Google Scholar
- Jőbsis, F. F. and Rosenthal, M., 1978, Cerebral energy consumption and provision: the predominance of neuronal oxidative metabolic processes, in: “Cerebral Vascular Smooth Muscle and Its Control,” K. Elliott and M. O’Connor, eds., Elsevier, New York, 129–148.Google Scholar
- Jobsis, F. F., Rosenthal, M., LaManna, J. C., Lothman, E., Cordingley, G., and Somjen, G., 1975, Metabolic activity in epileptic seizures, in: “Brain Work, Alfred Benzon Symposium VIII,” D. H. Ingvar and N. A. Lassen, eds., Munksgaard, Copenhagen, 185–196.Google Scholar
- Kreisman, N. R., Rosenthal, M., LaManna, J. C., and Sick, T. J., 1983a, Cerebral oxygenation during recurrent seizures, in: Advances in Neurology, Vol. 34: Status Epilepticus: Mechanisms of Brain Damage and Treatment, Delgado-Escueta, A., Wasterlain, C. G., Treiman, D. M., Porter, R. J., eds., Raven Press, New York, 231–239.Google Scholar
- Kreisman, N. R., Sick, T. J., Rosenthal, M., in press, Importance of Vascular responses in determining cortical oxygenation during recurrent paroxysmal events of varying duration and frequency of repetition, J. Cereb. Blood Flow Metabol. Google Scholar
- LaManna, J. C., Light, A. I., Peretsman, S. P., and Rosenthal, M., in press, Oxygen insufficiency during hypoxic hypoxia in rat brain cortex, Brain Res. Google Scholar
- Meldrum, B. S., 1981, Metabolic effects of prolonged epileptic seizures and the causation of epileptic brain damage, in: “Metabolic Disorders of the Nervous System,” F. C. Rose, ed., Pitman, London, 175–187.Google Scholar
- Reivich, M., Kuhl, D., Wolf, A., Greenberg, J., Phelps, M., Ido, T., Casella, V., Fowler, J., Hoffman, E., Alvari, A., Som, P., and Sokoloff, L., 1979, The (18F)-fluorodeoxyglucose method for the measurement of local cerebral glucose utilization in man, Circ. Res., 44:127–137.PubMedCrossRefGoogle Scholar
- Rosenthal, M., Duckrow, R. B., LaManna, J. C., Levasseur, and Patterson, J. L. Jr., 1982, Consequences of cerebral injury on oxidative energy metabolism measured in situ, in; Head Injury: Basic and Clinical Aspects, R. G. Grossman and P. L. Gildenberg, eds., Raven Press, New York, 69–78.Google Scholar
- Siesjo, B. K., 1978, “Brain Energy Metabolism,” John Wiley and Sons, Chinchester.Google Scholar
- Sylvia, A. L., Harik, S. I., LaManna, J. C., Wilerson, T., and Rosenthal, M., in press, Abnormalities of cerebral oxidative metabolism with aging and their relation to the central noradrenergic system, Gerontology. Google Scholar