[Epileptic absences. Studies on the structure, pathophysiology and clinical course of the seizure]

The temporal structure of absence symptoms of 59 patients--investigated by subtilized polygraphic video documentation technique--discloses a global functional scheme of motor activity directed from cranial parts of the body--like the ocular region--towards caudal parts. In analogy to the Jacksonian march of partial elementary motor seizures these findings are interpreted as a march of generalizing seizure activity of absence type. Its recognition allows to understand many motor as well as so-called "automatic" absence symptoms as correlated elements of a general organization plan. The development of a nuclear-layer model explains the fact, that in short-lasting absences often only ocular symptoms occur whereas in long lasting absences oral automatisms or motor activities of the extremities as well as gestural automatisms become manifest. New techniques of intensive seizure monitoring are carried out during therapy in patients with absences.