The generalized epileptic spike wave mechanism and the sleep wakefulness system

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Abstract

The observations presented were based on EEG and polygraphic analysis of 10 patients in all night natural sleep and of 99 patients under and after hexobarbital anesthesia. During natural and hexobarbital sleep, during the development of slow wave sleep the spike wave synchronization showed a definite activation, while during the deepening of sleep the spike wave pattern underwent morphologic changes. These sleep phase dependent changes were similar in the 3 cps and in the slow spike wave mechanisms; while the 2 kinds of spike wave mechanisms differed from each other in the dominant forms of transformed patterns. In one and the same patient, all the electromorphologic varieties known as the possible electrical concomitants of the spike wave mechanism, may develop. During the desynchronized sleep (REM sleep) no spike wave activation appeared. Arousing stimuli inhibited the spike wave pattern both in awake state and during a slightly decreased level of vigilance. If the stimuli had been administered when the patient was on a vigilance level deeper than the optimum for spike wave appearance, then the stimuli transiently awakening the patient to the optimal level would have activated the different morphologic phenomena of spike wave synchronization. Hence the arousing stimuli elicited or inhibited the spike wave synchronization depending on the level of vigilance upon which they were applied. The observed phenomena can be explained when pointing out that in the competition of the reticular arousal system and the slow wave sleep system the fluctuation of the vigilance toward the realm of the sleep system is an important determining factor in the appearance of spike wave synchronization. It was stressed that all the cerebral structures the electric or chemical stimulation of which elicited a spike wave pattern belong to the limbic mesencephalic circuit of Nauta. This system being identical or at least closely related to the system responsible for the organization of slow wave sleep, it is assumed that in the epileptic mechanism, characterized by a spike wave mechanism, a decrease of the tonus of the reticular arousal system and an epileptic functional disturbance in the slow wave sleep system were the main factors responsible for the determination of electroclinical phenomena. On the basis of this hypothesis, an attempt has been made to account for some hitherto unexplained features of petit mal epilepsy.

Original languageEnglish
Pages (from-to)293-314
Number of pages22
JournalActa Physiologica Academiae Scientiarum Hungaricae
Volume42
Issue number3
Publication statusPublished - 1972

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Wakefulness
Sleep
Hexobarbital
Arousal
Chemical Stimulation
Absence Epilepsy
REM Sleep
Electric Stimulation
Electroencephalography
Anesthesia

ASJC Scopus subject areas

  • Physiology

Cite this

The generalized epileptic spike wave mechanism and the sleep wakefulness system. / Halász, P.

In: Acta Physiologica Academiae Scientiarum Hungaricae, Vol. 42, No. 3, 1972, p. 293-314.

Research output: Contribution to journalArticle

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