Criteria for identifying cingulate epilepsies.

TLDR: The evidence by which the cingulate epilepsies can be identified is presented, recognizing that the pericallosal gyms, one of the cortical structures from which cortical epileptic discharges arise, is so important that the term “cingulate epilepsy” is appropriate to characterize a clinical, anatomical and electrographic entity.

Abstract: The concept of focal cortical epilepsies has changed during the past two decades. Our own point of view is not the same as in 1948 when we first monitored operations electrocort icographically . The interdependence of each neuronal population and the neuronal systems to which it is connected, and the interaction of all the neuronal loops make it necessary to define “focal cortical epilepsy” : hypersynchronous, rhythmic, self-sustaining neuronal discharges arising from a restricted portion ofthe cortex and spreading or propagating from that cortical area. Thus the anatomical lesions are not specific nor are the anatomical alterations restricted to the area of onset of the discharges. It is impossible to avoid a cybernetic concept of the activity of the neurones, and “localization” of a disturbance has to be considered in terms of modification of balance in a system of loops interconnected both inside a given structure (Le. cerebral cortex) and with distant formations (subcortical). In accordance with this scheme we realize that the pericallosal gyms, one of the cortical structures from which cortical epileptic discharges arise, is so important that the term “cingulate epilepsy” is appropriate to characterize a clinical, anatomical and electrographic entity. We would like to present the evidence by which the cingulate epilepsies can be identified.