CINGULATE, POSTERIOR ORBITAL, ANTERIOR INSULAR AND TEMPORAL POLE CORTEX 



1357 



seizures and is of special diagnostic importance, as it is 

 often the only clinical manifestation to indicate the 

 side of the lesion (169). In the unanesthetized, freely 

 moving cat a similar immediate tonic contraversion 

 can be induced from the periamygdaloid cortex and 

 parts of the subjacent amygdala (83, 87, 126, 12B, 

 166, 258). This tonic contraversion is not to be mis- 

 taken for the contraversive searching movements seen 

 in the "arousal' response. It appears likely that tonic 

 contraversion in most, if not all, temporal lobe seizures 

 is due to the involvement of these structures in the 

 epileptic discharge. The same applies to the general 

 rigidity and tonic extension of one or both contra- 

 lateral limbs, the twitching of the face (usually ipsi- 

 lateral) and the slow jerking moxemcnts of the limbs 

 frequently encountered in temporal lobe seizures 

 (25, 127, 258). 



VOCALIZATION, CHEWING, LICKING AND SWALLOWING 



MOVEMENTS. Vocalization resembling the sounds 

 which a monkey daily emits has been produced b\' 

 Smith by stimulation of the anterior portion of the 

 cingulate (235, 238) and hippocampal gyri (237). 

 This has been confirmed in the monkey (fig. 6A) 

 (126, 227, 232) and dog (44, 147). Ward (266), how- 

 ever, failed to obtain vocalization in monkeys and no 

 such responses have been obtained in cats. EEG 

 records taken during vocalization (232) showed no 

 change as might be expected if vocalization had been 

 a reaction to a painful stimulus. The response dis- 

 appears after deepening the anesthesia and after local 

 application of novocaine to the site of stiinulation, 

 and it persists after bilateral ablation of the cortical 

 areas for vocalization in the lower precentral region 

 (126). 



According to Kaada (126) and Sloan & Kaada 

 (232), vocalization can be elicited from the medial 

 surface only in an area limited to the forward upper 

 portion of the anterior cingulate region and to the 

 banks of the cingulate sulcus (fig. 6,4). In man, similar 

 vocalization has been e\oked by stimulation of the 

 'supplementary motor area' above this sulcus (33, 1 90) . 

 The possibility that the zone yielding vocalization in 

 monkeys represents the homologue of the 'supplemen- 

 tary motor area' of man should be considered (232). 



Rhythmic well-coordinated chewing movements 

 have been produced from the rostral pyriform cortex 

 and amygdala in monkeys (126, 166) (fig. 6.-1), cats 

 and dogs (126, 207, 246). This mastication usually 

 occurs after a surprisingly long latency of some 10 to 

 15 .sec. (126, 128) which is also characteristic of 

 mastication in temporal lobe seizures (i6g, 187, 188). 



FIG. 6. Ventromedial views of the right hemisplieie o( 

 Macaca mulalla. A: Points from which vocalization iV) and 

 mastication (encircled Al) were produced by electrical stimula- 

 tion. K Points from which a rise ( | ) or drop ( J, ) in arterial 

 pressure, salivation (S) or piloerection (*) were obtained. 

 The two zones encircled by dotted lines indicate areas from which 

 alteration in pyloric antral contractions was obtained by 

 stimulation. [From Kaada (126).] 



Swallowing and licking mo\ements and retching 

 have been elicited from the saine areas as well as 

 from the olfactory tubercle (126, 207). These responses 

 are all independent of the precentral motor cortex 

 (126) and fornix (246). The masticatory response 

 pos.sibly is mediated froin the pyriform cortex via the 

 amygdala and stria terminalis (126). 



Aiildinimic Rt'sponses 



CARDIOVASCULAR ALTERATIONS. It is a wcll-established 

 fact that the cardiovascular system can be influenced 

 from the motor and premotor and other cortical 

 areas outside those treated in this chapter [cf. Kaada 

 (126)]. Spencer (241) was the first to report arterial 



