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Consciousness and altered consciousness.

The notion of consciousness in the English scientific literature denotes a global ability to consciously perform elementary and intellectual tasks, to reason, plan, judge and retrieve information as well as the awareness of these functions belonging to the self, that is, being self-aware. consciousness can also be defined as continuous awareness of the external and internal environment, of the past and the present. The meaning of consciousness is different in various languages, but it invariably includes, the conscious person is capable to learn, retrieve and use information. Disturbance or loss of consciousness in the Hungarian medical language indicates decreased alertness or arousability rather than the impairment of the complex mental ability. Awareness denotes the spiritual process of perception and analysis of stimuli from the inner and external world. Alertness is a prerequisite of awareness. Clinical observations suggest that the lesions of specific structures of the brain may lead to specific malfunction of consciousness, therefore, consciousness must be the product of neural activity. "Higher functions" of human mental ability have been ascribed to the prefrontal and parietal association cortices. The paleocerebrum, limbic system and their connections have been considered to be the center of emotions, feelings, attention, motivation and autonomic functions. Recent evidence indicates that these phylogenetically ancient structures play an important role in the processes of acquiring, storing and retrieving information. The hippocampus has a key role in regulating memory, learning, emotion and motivation. Impaired consciousness in the neurological practice is classified based on tests for conscious behavior and by analyzing the following responses: 1. elementary reactions to sensory stimuli--these are impaired in hypnoid unconsciousness, 2. intellectual reactions to cognitive stimuli--these indicate the impairment of cognitive contents in non-hypnoid unconsciousness. Obviously, disturbance of elementary reactions related to alertness and disturbance of intellectual performance overlap. In conditions with reduced ability to react to or to perceive external stimuli the cognitive disturbance of consciousness cannot fully be explored.

Adult↗

[Status of the heart conduction system in patients with epileptic seizures].

Diagnostic computed transesophageal pacing was used to examine 45 patients with epileptic seizures of different genesis. Clinically, they had no signs of cardiac rhythm disturbances. 28 patients with heart arrhythmias and 30 practically healthy subjects served as control groups. 64.44% of the patients with epileptic seizures manifested different types of the clinically existing pathology in the conduction system of the heart. Among the practically healthy subjects, the analogous disorders accounted for 10%; only single premature heart beats were recorded during the examination. 60.71% of the control group patients with heart arrhythmias subjected to ECG studies demonstrated alterations of the epileptic type. It is concluded that there is a close relationship between the epileptic process and pathology of the conduction system of the heart.

Adolescent↗

[Ultrastructural characteristics of the reticular thalamic nucleus neurons in WAG/Rij rats].

The aim of this study was to investigate the ultrastructure of the reticular thalamic nucleus (RTN) in rats of WAG/Rij strain, an established model for human absence epilepsy. Most RTN neurons are medium-to large-sized and have either dark or light appearance, depending on their functional state. Moreover, small-sized neurons with short axons are present, their characteristics being described for the first time.

Animals↗

[Characteristics of paradoxical sleep in different types of epileptic seizures].

In 136 patients with different forms of epileptic strokes paradoxal sleep (PS) was studied. Shifts of a qualitative and quantitative character were revealed. The latter, in particular was expressed in a dissociative type of PS when muscular tension was preserved. The found changes were expressed more severely in patients with polymorphic and psychomotor strokes in the frontotemporal and frontal localization of the epileptic focus. In general, the same patients registered paroxysmal and epileptic activity in the period of PS, what was infrequently found in other forms of epileptic strokes, however, it had never coincided with the registration of rapid ocular movements. The role of PS physiological mechanisms in suppression of epileptic activity and possible ways of searching for more effective antiepileptic measures are discussed.

Adolescent↗

[Neurogenic pulmonary edema complicating a generalized epileptic crisis].

Epileptic seizures may be rapidly followed by neurologic pulmonary edema (NPE). While the outcome of respiratory failure may be spontaneously favourable, in some cases death may occur due to respiratory and/or neurologic dysfunction. Two patients with NPE are described, one of whom survived without treatment and is in good health. In the other the outcome was rapidly fatal despite prompt and vigorous medical treatment.

Adult↗

[The startle response and epilepsy].

Startle responses (SR) are described as epileptic and non-epileptic attacks and their mechanisms are poorly understood. Long-loop reflexes and a satisfactory response to L-tryptophan treatment have only seldom been published in this condition. This prompted us to report a case with epilepsy and startle-induced tonic spasms, the latter refractory to all conventional medication except for L-tryptophan. Special emphasis is placed on the electrophysiological findings. Similar observations of non-habituation of SR in post-anoxic brain damage and in the case of startle epilepsy possibly suggest a deficit of cortical inhibition, probably in the supplementary motor area, rather than brain stem dysfunction in both instances.

Adult↗

[Relation between spina bifida occulta and various epileptic syndromes].

Radiographs of the lumbar vertebral column and sacral region obtained for 182 epileptic patients after spina bifida occulta were studied. Spina bifida occulta was twice as common in patients with idiopathic epilepsy as in those with symptomatic epilepsy and twice as common as in the normal population. A relationship between spina bifida occulta and idiopathic epilepsy is discussed.

Adolescent↗