Comparison of anaesthetic- and seizure-induced states of unconsciousness: a narrative review. (January 2021)

• Record Type: Journal Article
• Authors: Gruenbaum, Benjamin F.
• Is Part Of: British journal of anaesthesia. Volume 126:Number 1(2021)
• Page Start: 219
• Page End: 229
• Publication Date: 2021-01
• Subjects: awareness -- general anaesthesia -- mechanism -- seizure -- unconsciousness; Anesthesiology -- Periodicals; Anesthesia -- Periodicals; 617.9605
• DOI: 10.1016/j.bja.2020.07.056
• Languages: English
• ISSNs: 0007-0912

Abstract

Summary: In order to understand general anaesthesia and certain seizures, a fundamental understanding of the neurobiology of unconsciousness is needed. This review article explores similarities in neuronal and network changes during general anaesthesia and seizure-induced unconsciousness. Both seizures and anaesthetics cause disruption in similar anatomical structures that presumably lead to impaired consciousness. Despite differences in behaviour and mechanisms, both of these conditions are associated with disruption of the functionality of subcortical structures that mediate neuronal activity in the frontoparietal cortex. These areas are all likely to be involved in maintaining normal consciousness. An assessment of the similarities in the brain network disruptions with certain seizures and general anaesthesia might provide fresh insights into the mechanisms of the alterations of consciousness seen in these particular unconscious states, allowing for innovative therapies for seizures and the development of anaesthetic approaches targeting specific networks.