Primary and Secondary Bilateral Synchrony in Epilepsy

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Abstract
THE MECHANISMS underlying human seizures generalized from the start and those that become so secondarily have not been clearly elucidated. The experimental data accumulated in the last two decades still seem to weigh in favor of a subcortical integrating system as the main agent involved,1,2despite the arguments based on electrographic observations3,4and on findings of depth electrography and stimulation in man,5,6as well as those based on findings in free cortical slabs or on cortical-callosal preparations in animals.7,8 While waiting for further clarification of the mechanisms, the clinician, whenever confronted by electroencephalograms with bilaterally synchronous discharges of the spike and wave variety, associated or not with focal features, is faced with the task of distinguishing between "primary" and "secondary bilateral synchrony." The latter term was first introduced by Penfield9and Tuckel and Jasper10to protect the integrity of the "centrencephalic" hypothesis

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