J.Jpn. Surg. Soc.. 55(3): 263-273, 1954

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Original article

PERIPHERAL BLOOD CIRCULATION OF EPILEPSY (PLETHYSMOGRAPHIC STUDIES ON THE CEREBRAL LESIONS, PAPT 2.)

1) The peripheral circulatory conditions in 130 cases of epilepsy have been examined through the period of hospitalization using a photoelectric plethysmograph between September, 1949 and September, 1952. The examination was mainly performed during interseizure period, and in some cases the reconding was obtained closely to the seizure.
2) During these observations, greater or less vasoconsriction was generally observed (80%). This vasoconstriction had no relation to to the cause of epilepsy, and it was less observable in cases of psychomotor seizure and localized convulsive seizure, whereas it was more frequently observed in cases of grand mal seizure. The patients who have less frequent seizures showed slighter vasoconstriction, and the vasoconstriction also related to the duration of the disease. It had no relation to the age, and sex, but it was more common in cases of hypertension. Moreover, diminution of the vasoconstriction after treatment was coincidental with the effect of treatment in alleviating the seizures.
3) The laterality between the fingertips of the two hands was observed specially in focal epilepsy cases, and the laterality was observed as a contralateral vasoconstriciton to the focus. On the contraly, in cases of nonfocal epilepsy the laterality was invisible. When the focus is localized in the temporal lobe, the laterality will appear in 50% This mostly disappeared or diminished after successful treatment.
4) The vasoconstriction was released suddenly after the seizure, and then it will gradually increase, untill the next seizure, and it reaches its maximum just before the seizure.
5) Plethysmographical tracing was performed during Cardiazol activation of seizure in 40 times (22 cases). The same result obtained during natural seizure and induced seizure. There were no marked fluctuations in blood pressure and pulse rate.
6) The same result was obtained also in animal experiment,
7) Utilizing the marked change in plethysmographical record, the anticipation of the coming seizure could be successfully performed in some cases.
8) Any procedure which will release the vasoconstriction in some extent, is much effective supplimentary treatment of anticonvulsant therapy, at least in cases which show the vasoconstriction.
9) Peripheral vascular response of the cerebral lesions was already discussed. In epilepsy, some findings mentioned above will be explained by a hypothesis as follows: If an attack, although it begins by discharge in certain neurons, spreads to involve the autonomic aeurons governing cardiovascular function either in the cortex or diencephalon, those vasomotor changes would be observed.
(author's abstract)

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