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

Vuilleumier, Patrik; Assal, Frédéric; Blanke, Olaf; Jallon, P.

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Title		Distinct behavioral and EEG topographic correlates of loss of consciousness in absences
Authors		Vuilleumier, Patrik Assal, Frédéric Blanke, Olaf Jallon, P.
Published in		Epilepsia. 2000, vol. 41, no. 6, p. 687-693
Abstract		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.
Keywords		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
Identifiers		PMID: 10840400
Full text		Article - Limited access to UNIGE Other version: http://www3.interscience.wiley.com/journal/119003574/abstract
Structures		Faculté de médecine / Section de médecine fondamentale / Département de neurosciences fondamentales
Research group		Neuropsychologie et neurologie comportementale (951)
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. https://archive-ouverte.unige.ch/unige:10490