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The Neuroscientist, Vol. 9, No. 5, 301-310 (2003)
DOI: 10.1177/1073858403255624
© 2003 SAGE Publications

Why do Seizures Cause Loss of Consciousness?

Hal Blumenfeld

Departments of Neurology and Neurobiology Yale University School of Medicine, hal.blumen-feld{at}yale.edu

Jacob Taylor

Program in Cognitive Science Yale University

Model systems are needed for the scientific investigation of consciousness. A good model system should include variable states of consciousness, allowing the relationship between brain activity and consciousness to be investigated. Examples include sleep, anesthesia, focal brain lesions, development, evolution, and epilepsy. One advantage of epilepsy is that changes are dynamic and rapidly reversible. The authors review previous investigations of impaired consciousness in epilepsy and describe new findings that may shed light on both normal and abnormal mechanisms of consciousness. Abnormal increased activity in fronto-parietal association cortex and related subcortical structures is associated with loss of consciousness in generalized seizures. Abnormal decreased activity in these same networks may cause loss of conscious-ness in complex partial seizures. Thus, abnormally increased or decreased activity in the same networks can cause loss of consciousness. Information flow during normal conscious processing may require a dynamic balance between these two extremes of excitation and inhibition.

Key Words: Epilepsy • Thalamus • Brainstem • SPECT • Frontal lobe • Attention


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