Abstract
The involvement of the cerebral cortex in the initiation, spread, and expression of many types of seizures was recognized as early as the nineteenth century by Hughlings Jackson (46,47). This was confirmed through observations of seizures resulting from electrical cortical stimulation in animals (25). Functional localization studies and electroencephalography (48,70) led to further emphasis on the role of the cerebral cortex, since subcortical contributions to unaveraged scalp recordings are insignificant (19). Nevertheless, noncortical structures are undoubtably involved in virtually all epileptic seizures since all cortical regions have direct subcortical connections which join these areas to systems subserving motor, sensory and other functions. Forty years ago, Penfield and Jasper (49,69,70) postulated an upper brainstem neural system, the “centrencephalic integrating system” with symmetric ascending connections with each hemisphere. Primary generalized seizures of all types were believed to originate in this system (70) and it was also felt to mediate the transformation of focal cortical seizures into generalized convulsions. This system was tentatively identified with the mesencephalic reticular formation and the midline and intralaminar thalamic nuclei and was thought to also be involved in higher cerebral functions such as voluntary movement, memory and consciousness itself (70).
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Miller, J.W., Ferrendelli, J.A. (1988). Some Subcortical Mechanisms Involved in Experimental Generalized Seizures. In: Dichter, M.A. (eds) Mechanisms of Epileptogenesis. Springer, Boston, MA. https://doi.org/10.1007/978-1-4684-5556-4_7
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