Cognitive deficit related to seizure pattern in centrencephalic epilepsy

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Abstract
Centrencephalic epilepsy is characterized by an electroencephalogram showing a bilaterally synchronous onset of abnormality which consists of wave-and- spike activity at or near a frequency of 3 per second. This type differs from local cortical epilepsy in having a subcortical origin which has widespread connections with cortical areas. Continuous performance and memory tests have shown a functional differentiation between the focal and non-focal types. The present report consists of the results of a variety of perceptual and memory tests given to a group of centrencephalic patients and those with focal epilepsy. The centrencephalic group scored lower than the group with focal cortical epilepsy. Within the centrencephalic group, however, patients with myoclonic jerks were found to be uninpaired. It is possible that myoclonic jerks may be associated in some way with the reticular formation whereas other types of non-focal seizures have their origin in the more rostral non-specific thalamic system. The slow response in the tests, therefore, may reflect a chronic dysfunction of the more rostral "attention" system or of other structures which normally influence it and which may be exaggerated during wave and spike bursts.