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Seizure patterns and other clinical features were analyzed in 55 epileptic patients with electrographic evidence of exclusive or predominant occipital involvement. Few statistically significant differences in clinical or ictal patterns were found between subjects with purely focal occipital involvement and those with temporal and temporoparietal spread or minor additional independent foci. On the other hand, cases with bilateral synchronous occipital spike activity appeared to reflect a different type of epileptic disorder. Clinical pleomorphism was more apparent than is commonly conceived; thus, although the incidence of visual auras was relatively high (47 percent), epigastric, psychic, somatic, and other sensory phenomena were not infrequently encountered. Ictal motor patterns were most commonly (53 percent) nonfocal or absent, but partial or focal motor attacks and psychomotor seizures were amply represented. Ictal features with their localizing and lateralizing reliability were also analyzed and discussed in relation to those found in a companion study of seizures of fronto-centro-parietal origin.

IN THIS symposium, Professor Magoun has described some of the properties of the reticular system of the brain stem, with particular reference to mechanisms underlying alertness or arousal of the organism and its effect upon the electrical activity of the cortex. Emphasis has been placed upon that portion of this system lying in the basal part of the diencephalon and midbrain, with some extension into the mesial portion of the thalamus. From the results presented it would seem that the ascending portion of the reticular system in the more caudal part of the brain stem exerts its effect upon the electrical activity of the cortex in a generalized manner, without evidence of topographic localization.In the thalamus there exists a more highly differentiated portion of this system, which we have tentatively described as the thalamic reticular system. Electrical stimulation within this system is capable of exerting a similar activating influence

INTEREST in the subcortical connections of the temporal lobe has increased in recent years, owing to the frequency with which this area becomes the focus of epileptic discharge.The clinical picture of the form of epilepsy arising from the anterior temporal region has been well known since its original description by Hughlings Jackson1 in 1871, and its psychical, visceral, motor, and special sensory manifestations do not need a detailed description here.Recent emphasis upon temporal lobe seizures has been due chiefly to the work of Jasper2; Jasper and Kershman3; Gibbs, Gibbs, and Fuster4; MacLean5; Penfield and Flanigin6; Bailey and Gibbs7; Jasper, Pertuiset, and Flanigin,8 and Green, Duisberg, and McGrath.9 The bilaterally synchronous, nonlocalized electroencephalographic abnormalities, which were first described by Gibbs, Gibbs, and Lennox10 in 1938 as diagnostic of "psychomotor epilepsy," have been more clearly defined in the later studies

INTRODUCTION The value of electroencephalography in the diagnosis and localization of primary tumors of the brain is well recognized and established since the pioneer work of Grey Walter.1,2 Less definite information is available regarding the efficacy of the method in confirming or revealing cerebral metastases: the reports are generally confined to relatively small series of metastatic tumors, accompanied by neurologic manifestations3-5 and in many cases verified exclusively or mostly through surgical intervention.4,6-8 Other reports either deal with isolated cases9-13 or treat the EEG aspect of relatively large series of brain neoplasms without separate analysis of gliomas and metastases.14-19Yet diagnostic problems of primary and secondary brain tumors are often quite different. The patient with a primary tumor may be in good general health, his clinical state being largely the result of the neurological lesion per se. Patients with matastatic tumors are usually in very

INTRODUCTION In recent years it has become increasingly apparent that seizures characterized by curious visceral and psychical states and automatism associated with a predominantly temporal localization of electroencephalographic abnormality form a large proportion of clinical seizure problems. This has been reported to be as high as 75%.1 As more evidence has accumulated, the problems associated with a sound understanding of its mechanism have vastly expanded.The present study consists in a series of observations of patients subject to attacks of this sort. An attempt has been made in a number of pentylenetetrazol (Metrazol)-induced seizures to record graphically as many clinical, autonomic and electroencephalographic phenomena as possible which are interrelated by the same time base. By this means it was hoped to discover correlates that might be useful in understanding the mechanism of the ictal features of temporal lobe epilepsy. METHODS The material selected for the present study consisted of

Action potentials of single cells, recorded by means of extracellular microelectrodes from the cat's cerebral cortex after topical application of penicillin, undergo characteristic changes in the course of seizure episodes. In individual neurons, these changes in spike configuration are fully reversible and are repeatedly observed with each of such episodes. Two alternative interpretations offered for these findings appear to be critically dependent upon the relationship between the position of the microelectrode and the cell itself: there might be a transitory failure of the spike to invade part of the neuronal membrane or transitory neuronal swelling.

This book is directed not only to the neurologist but also, and chiefly, to the general practitioner who uses electroencephalography in his practice. To this effect, an effort is made to present a "synthesis of the daily clinical situations in which the usefulness or necessity might arise to request an EEG examination" and "to furnish a minimum of theoretical and practical notions on the possibilities and limitations of the EEG technique." According to the author, the book should help the nonspecialist not only in interpreting the tracing but in understanding the EEG report, thus making possible the most profitable use of the latter in diagnostic and prognostic problems and in the selection of therapy.Notwithstanding the modesty of intentions, the book is definitely the best of its kind ever to appear in the Italian literature and can be favorably compared with most of the monographs dealing with electroencephalography which have