The borderland of epilepsy : faints, vagal attacks, vertigo, migraine, sleep symptoms and their treatment.

  • Gowers, W. R. (William Richard), 1845-1915.
Date:
1907
Catalogue details

Licence: In copyright

Credit: The borderland of epilepsy : faints, vagal attacks, vertigo, migraine, sleep symptoms and their treatment. 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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    sound-vibrations excite nerve impulses, there is no evidence that the canal nerves have to do with hearing. Nor indeed do the impulses excited in them seem to give rise to any true sensation. They seem to pass to a centre where they meet with other impulses from the eyes, muscles, and other sources, with which they agree in normal condition, in a harmony that is unfelt. Any discord between the impressions affects consciousness as a distressing sensation, which may give no suggestion of its origin. Vertigo is the result. It is, however, a very complex result. The disturbance of equilibrium must be perceived through the cerebral hemispheres, and we can thus understand at least the fact that it is often similar to the vertigo that seems to origi- nate in the cortex—that of epilepsy. In each there may be a sense of movement towards one side, forwards, or back- wards (subjective vertigo), or a sense of similar movement in external objects (objective vertigo), or there may be a movement in the sufferer of the same kind, an actual turn- ing or a fall, apparently due to a motor process and not only to the loss of balance (motor or actual vertigo). As a rule all three—objective, subjective, and actual vertigo— are in the same direction. This can be understood on the explanation suggested by Hughlings Jackson that vertigo is a sensation of motor origin. It is a feeling, but due to the perception of a process in the motor centres, or to the results of this. It causes a perception of movement when it is too slight to cause actual movement. In epilepsy we may ascribe it to an inequality in the commencing motor discharge in the two hemispheres, or to the early discharge beginning in one hemisphere only, before consciousness is lost. Such inequality is often manifested in the convulsion by the deviation of the head and eyes towards the side most convulsed. A slight discharge, too slight to cause any movement,