Central pattern generators for a common semiology in fronto-limbic seizures and parasomnias. A neuroethologic approach

Division of Neurology, Department of Neurosciences, Bellaria Hospital, University of Bologna, Italy, Via Altura 3, I-40139 Bologna, Italy.
Neurological Sciences (Impact Factor: 1.45). 01/2006; 26 Suppl 3(S3):s225-32. DOI: 10.1007/s10072-005-0492-8
Source: PubMed

ABSTRACT Central pattern generators (CPGs) are genetically determined neuronal aggregates in the mesencephalon, pons and spinal cord subserving innate motor behaviours essential for survival (feeding, locomotion, reproduction etc.). In higher primates CPGs are largely under neocortical control. We describe how certain motor events observed in parasomnias and epileptic seizures could have similar features and resemble motor behaviours, which can be the expression of the same CPG. Both epilepsy and sleep can lead to a temporary loss of control of neomammalian cortex that facilitates through a common platform (arousal) the emergences of stereotyped inborn fixed action patterns. Therefore we suggest that, independently from the nature of the trigger, be it a seizure or a parasomnia, the same CPGs can be involved, "caught up", leading to a common motor semiology (the "Carillon theory").

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    • "Differential diagnosis between PNES and epileptic seizures, in particular with a medial frontal onset, can be challenging because both of them may consist of bizarre movements and both may share an uninterpretable EEG due to movement-related artifacts. In this case, video-EEG recordings allowed a clear distinction of hypermotor seizures from PNES, in particular crucial semiological features of frontal seizures were represented by abrupt start and end of movements and by the presence of frontal signs, such as grasping and pronation [1]. These elements were absent in PNES episodes, which developed gradually and terminated progressively. "
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    ABSTRACT: We present the case of a 13-year-old child with nocturnal frontal lobe epilepsy (NFLE) related to a right cingulate gyrus cortical dysplasia, who also presented with psychogenic nonepileptic seizures (PNES) and interictal antisocial behavior. The association of drug-resistant epilepsy with behavioral disorders is well established, but the role of epilepsy surgery in these patients is still controversial, especially in children. The key finding is represented by the excellent long-term outcome on both epilepsy and behavioral dysfunction after the surgical excision of the cingulate gyrus cortical dysplasia.
    Epilepsy and Behavior Case Reports 12/2015; 3. DOI:10.1016/j.ebcr.2015.01.002
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    • "In our opinion, since the IK failed to be demonstrated by stimulation studies and the patients also shared complex emotional backgrounds, this automatism may very well be a release phenomenon. Tassinari et al. postulated that epileptic seizures can lead to a temporary loss of neocortical control on the central pattern generators (CPGs) which are located in the brain stem and spinal cord and induce some behaviors or emotions thought to be innate and essential for survival [10] [11]. This hypothesis may be an explanation for some ictal automatisms presumed to be due to a release phenomenon. "
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    ABSTRACT: This study is based on the psychodynamic and neurological analysis of three Turkish patients who displayed ictal kissing automatism during their seizures. To unveil the probable underlying causes of their kissing behaviors, all patients underwent psychiatric interviews after being evaluated by ictal video-EEG recordings. The group consisted of two females (ages 35 and 29) and one male (age 26). In addition to prominent oral automatisms, each patient also displayed behaviors of kissing or blowing kisses to individuals at close proximity. Seizures were related to the right temporal lobe in two patients and the left temporal lobe in one patient. Magnetic resonance imaging showed mesial temporal sclerosis in two of the patients (one left, one right) and was normal in one. According to the DSM-IV-TR criteria, each of the three patients also suffered from major depression, while the psychodynamic interviews revealed traumatic childhood histories and intense unfulfilled affective needs.
    Epilepsy & Behavior 09/2013; 29(2). DOI:10.1016/j.yebeh.2013.07.032 · 2.26 Impact Factor
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    • "On the other hand, NREM parasomnias are characterized by a state dissociation, in which two states (wake, sleep) occur simultaneously (Bassetti et al., 2000). In addition, it has been proposed that inhibition of supraspinal influence on locomotor centers is an additional condition for NREM parasomnias to occur (Tassinari et al., 2005). While these mechanisms may explain motor disinhibition during the NREM or REM episode, the pathophysiological mechanisms underlying the specific variety of behaviors expressed during parasomnia episodes remain unresolved. "
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    ABSTRACT: Recent studies in sleep and dreaming have described an activation of emotional and reward systems, as well as the processing of internal information during these states. Specifically, increased activity in the amygdala and across mesolimbic dopaminergic regions during REM sleep is likely to promote the consolidation of memory traces with high emotional/motivational value. Moreover, coordinated hippocampal-striatal replay during NREM sleep may contribute to the selective strengthening of memories for important events. In this review, we suggest that, via the activation of emotional/motivational circuits, sleep and dreaming may offer a neurobehavioral substrate for the offline reprocessing of emotions, associative learning, and exploratory behaviors, resulting in improved memory organization, waking emotion regulation, social skills, and creativity. Dysregulation of such motivational/emotional processes due to sleep disturbances (e.g., insomnia, sleep deprivation) would predispose to reward-related disorders, such as mood disorders, increased risk-taking and compulsive behaviors, and may have major health implications, especially in vulnerable populations.
    Frontiers in Psychology 07/2013; 4:474. DOI:10.3389/fpsyg.2013.00474 · 2.80 Impact Factor
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