Epilepsy : a study of the idiopathic disease.

  • Turner, William Aldren, 1864-1945.
Date:
1907
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Licence: In copyright

Credit: Epilepsy : a study of the idiopathic disease. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    other than through the debilitating influences which their coexistence with epilepsy entails. The Convulsive Factor. The only entirely characteristic symptom of epilepsy is the periodic recurrence of attacks of loss, or impairment, of con- sciousness, sometimes accompanied by convulsion. But even this definition requires modification, as there are occasional inter-paroxysmal phenomena in epilepsy without loss of con- sciousness, and some impairment of consciousness may be found in epileptoid states, such as aural vertigo, and hystero- epilepsy. The doctrine originally propounded by Herpin1 has been adopted in this work as the basis of the description of the convulsive phenomena of epilepsy, viz., that the incomplete attacks, embracing the aura-sensations, cramps, spasms, and partial convulsions of the inter-paroxysmal periods, are the initial phenomena of the complete seizures, which have been arrested at some stage of their course. The most logical con- ception, therefore, of the spasmodic and convulsive symptoms of epilepsy lies in regarding them as links of a chain, and not as isolated features in a convulsive disorder. In consequence, there may be found in the same person all gradations of paroxysms from the simple aura, through the incomplete attack, up to the fully developed complete epileptic fit. Applying the same principle to the clinical groupings of fits, there may be observed all degrees of combination of seizure, from short series of incomplete minor or major attacks, through serial outbursts up to the complete picture of the status epilepticus. As the minor type of fit is merely an aborted, or modified major fit, so the serial outburst is a modified development of the status epilepticus. Short series of minor and major fits are gradational stages towards the more fully developed serial epilepsy, which is in turn a subacute status attack. Like other disorders, epilepsy, through its convulsive symptoms, may present both an acute and a chronic develop- ment. There are rare instances in which recurring attacks of the status epilepticus form the clinical type of the disease; on the other hand, an attack of status epilepticus may be the acute commencement of epilepsy, which is continued in a chronic 1 Herpin, Les Accfo Incomplete oVEpile.psie, Paris, 1867.