Affiliations: Department of Neuropsychiatry, University of
Birmingham and BSMHFT, Birmingham, UK | Sobell Department of Motor Neuroscience and Movement
Disorders, Institute of Neurology, UCL, London, UK
Note: [] Corresponding author: Dr. Andrea Eugenio Cavanna, Department of
Neuropsychiatry, Birmingham and Solihull Mental Health NHS Foundation Trust,
Barberry Building, Birmingham B152FG, UK. E-mail: A.Cavanna@ion.ucl.ac.uk
Abstract: Alterations in consciousness are central to epileptic
manifestations, and involve changes in both the level of awareness and
subjective content of consciousness. Generalised seizures are characterised by
minimal responsiveness and subjective experience whereas simple and complex
partial seizures demonstrate more selective disturbances. Despite variations in
ictal origin, behaviour and electrophysiology, the individual seizure types
share common neuroanatomical foundations generating impaired consciousness.
This article provides a description of the phenomenology of ictal consciousness
and reviews the underlying shared neural network, dubbed the 'consciousness
system', which overlaps with the 'default mode' network. In addition, clinical
and experimental models for the study of the brain correlates of ictal
alterations of consciousness are discussed. It is argued that further
investigation into both human and animal models will permit greater
understanding of brain mechanisms and associated behavioural consequences,
possibly leading to the development of new targeted treatments.
