An unaware agenda: interictal consciousness impairments in epileptic patients

AMARILLO, Y.; IBAÑEZ, A.; MIKULAN, E.; VAUCHERET, E.; BEKINSCHTEIN, T. A.; IBAÑEZ, A.; GARCIA, A. M.; GARCIA, M. C.; VAUCHERET, E.; BEKINSCHTEIN, T. A.; MOGUILNER, S.; GARCIA, A. M.; AMARILLO, Y.; GARCIA, M. C.; MOGUILNER, S.; MIKULAN, E.

Neuroscience of Consciousness

Oxford University Press

Año: 2017

2057-2107

Consciousness impairments have been described as a cornerstone of epilepsy. Generalized seizures are usually characterized by a complete loss of consciousness, whereas focal seizures havemore variable degrees of esponsiveness. In addition to these impairments that occur during ictal episodes, alterations of consciousness have also been repeatedly observed between seizures (i.e. during interictal periods). In this opinion article, we review evidence supporting the novel hypothesis that epilepsy produces consciousness impairments which remain present interictally. Then, we discuss therapies aimed to reduce seizure frequency,whichmaymodulate consciousness between epileptic seizures.We conclude with a consideration of relevant pathophysiologicalmechanisms. In particular, the thalamocortical network seems to be involved in both seizure generation and interictal consciousness impairments, which could inaugurate a promising translational agenda for epilepsy studies.