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The Role of Arousal and “Gating” Systems in the Neurology of Impaired Consciousness

Schiff, Nicholas D; Plum, Fred

Journal of Clinical Neurophysiology: September 2000 - Volume 17 - Issue 5 - p 438-452
Review Article

Summary A brief taxonomy of neurologic disorders resulting in global impairments of consciousness is presented. Particular emphasis is placed on focal injuries of subcortical structures that may produce disorders that are otherwise associated to large bilateral cortical injuries. A distinction between subcortical arousal and “gating” systems is developed. Both clinical and experimental studies are reviewed in the context of these disorders and their possible underlying mechanisms.

Department of Neurology and Neuroscience, Weill Medical College of Cornell University, New York, New York, U.S.A.

Address correspondence and reprint requests to Dr. Nicholas D. Schiff, Department of Neurology and Neuroscience, Weill Medical College of Cornell University, 1300 York Avenue, New York, NY 10021.

This manuscript is adapted from the Electronic Seminar target article: Schiff ND, Plum F. The neurology of impaired consciousness: global disorders and implied models. Association for the Scientific Study of Consciousness. http://athena.english.vt.edu/cgi-bin/netforum/nic/a/1. Several additional clinical observations of the role of these systems, particularly in neurologic disorders that exhibit fluctuations, are discussed therein.

Copyright © 2000 American Clinical Neurophysiology Society