Scientific article

Distinct behavioral and EEG topographic correlates of loss of consciousness in absences

Published inEpilepsia, vol. 41, no. 6, p. 687-693
Publication date2000

PURPOSE: To describe the behavioral and EEG topographic correlates of absences with 3-Hz generalized spike-waves and partitioned impairment of consciousness. METHODS: Two adult women had so-called "phantom" absences, characterized by brief and mild impairments of consciousness that were previously inconspicuous to both patient and physician. Neuropsychological examination was performed under video-EEG monitoring during absence status. EEG topographic mapping of spike-wave discharges was obtained in the two cases. RESULTS: Only mild attentional and executive disturbances were observed during absence status despite prolonged discharges. Spike-wave bursts were associated with selective impairment in the initiation of response and self-generated action, whereas short-term storage of external information during discharges was fully preserved. This is consistent with a predominant involvement of frontomesial cortex demonstrated by topographic mapping of spike-wave discharges in the two cases. By contrast, in two other patients with typical absences and a complete lack of retention for information given during the discharges, topographic mapping found a more lateral frontal involvement by spike-wave activity. CONCLUSIONS: Different types of absence seizures may impair distinct components of conscious behavior. A predominant involvement of frontomesial thalamocortical circuitry may underlie an "inconspicuous" disorder of consciousness as seen in phantom absences with selective loss of initiation and goal-oriented behavior, whereas involvement of more lateral frontal areas in typical absences may additionally disrupt working memory processes.

  • Adult
  • Aged
  • Brain Mapping
  • Cerebral Cortex/physiology/physiopathology
  • Cognition/physiology
  • Electroencephalography/ statistics & numerical data
  • Epilepsy, Absence/diagnosis/ physiopathology
  • Female
  • Frontal Lobe/ physiopathology
  • Functional Laterality/physiology
  • Gyrus Cinguli/physiopathology
  • Humans
  • Memory, Short-Term/physiology
  • Middle Aged
  • Neural Pathways/physiology/physiopathology
  • Neuropsychological Tests/statistics & numerical data
  • Sensation/physiology
  • Thalamus/physiology/physiopathology
  • Unconsciousness/diagnosis/ physiopathology
Citation (ISO format)
VUILLEUMIER, Patrik et al. Distinct behavioral and EEG topographic correlates of loss of consciousness in absences. In: Epilepsia, 2000, vol. 41, n° 6, p. 687–693.
Updates (1)
ISSN of the journal0013-9580

Technical informations

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