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

  • Gowers, W. R. (William Richard), 1845-1915.
Date:
1907
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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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    increase of his tinnitus, with this change in character, often followed, for a short time, the act of rising from the sitting position. This fact is curious. A change of position often induces giddiness in labyrinthine vertigo, presumably because it causes a sudden change of pressure of the endolymph on the hypersensitive structures in the ampullae of the canals. The pressure of the endolymph must be similarly varied in the part of the labyrinth concerned in hearing, and if the changes are so situated that the influence exerted by rising can act upon them, we may understand that an increase in the tinnitus may be thus induced. Indeed, the pulsatile character of tinnitus must be due to the sensitiveness of the struc- tures to changes of pressure. In this patient the left ear gradually became quite deaf, and then all giddiness ceased. Again, a man, aged 41 years, had suffered for some years from hissing tinnitus on the left side, on which he could hear no note of Galton's whistle, although it was well heard on the right. Recently he had had attacks in which a momentary wave seemed to pass over his head, with a movement of objects to the left; he fell to the left, and was unconscious for a second or two. Sometimes the apparent movement was to the right, and then he fell in that direction. The resemblance of such attacks to minor epilepsy is so close that doubt may be felt whether the association with labyrinthine changes is sufficient ground for regarding the case as essentially vertigo. But before the attacks became so brief he had slighter, more prolonged attacks of giddiness, in which the ground seemed to recede, and if walking he would fall, distinctly from the unsteadiness. These attacks were followed bv J nausea, and they make the nature of the case certain. I may mention, lastly, the case of a gouty woman, aged 67 years, who had complete left-sided deafness through