Against vivisection: Charcot and Pitres' discovery of the human motor cortex and the birth of modern neurosurgery and of the surgical treatment of epilepsy.

This article addresses the discrepancy between Edouard Hitzig's and David Ferrier's findings on the cortical localization of movements in animals and Jean-Martin Charcot's findings in humans. The results of Hitzig's and Ferrier's vivisections were criticized by experimentalists in England and France as discordant, irreproducible, and inconclusive, and they were rejected by clinicians as irrelevant. Charcot addressed the gap between animal and human motor function by correlating motor deficits and focal epileptic seizures in patients to their autopsy findings. By this method he discovered the functional organization of the human motor cortex and produced the first accurate human motor brain map. Ferrier, William Osler, and Hughlings Jackson acknowledged Charcot's findings, and his findings guided the first neurosurgeons in localizing and resecting intracranial mass lesions presenting with focal epileptic seizures. Although his contributions in these fields have been neglected by modern historians, Charcot made significant contributions to the neurobiology of the human motor system, to epileptology, and to the birth of modern neurosurgery.

[Late forced emigration without perspectives: Alfred Hauptmann and Adolf Wallenberg]. / Späte Zwangsemigration ohne Perspektive: Alfred Hauptmann und Adolf Wallenberg.

Archival documents and further biographical testimonies reveal that dismissal and expulsion on racist grounds also affected neurologists in leading clinical positions and at an advanced age. Alfred Hauptmann (1881-1948), full professor for neurology and psychiatry in Halle/Saale, member of the Leopoldina and discoverer of phenobarbitone treatment for epilepsy, emigrated first to Switzerland and then to the USA after the anti-Jewish pogroms in November 1938 and a subsequent "protective custody" imposed on him at the age of 58 years. Adolf Wallenberg (1862-1949), a self-made neurologist, described the syndrome later named after him in 1895. As a clinician he carried out research in the field of neuroanatomy until the National Socialists ousted him from his workplace in Danzig. At the age of 77 years, he emigrated to the USA via Great Britain, but did not manage to settle down again in his profession. For both physicians, neurology was their purpose in life, they felt patriotically attached to their home country and saw no future for themselves after their late forced emigration. Hauptmann is today commemorated by an award for experimental and clinical research on epilepsy, Wallenberg by the German Neurological Society award for outstanding achievements in the fields of cerebrovascular diseases, brain circulation and brain metabolism.

Historical Overview of the "Firing" Liaison between Brain Tumors and Epilepsy.

This review addresses, in a critical historical perspective, the link between seizures and endocranic neoplasms. Folkloric descriptions of epilepsy can be found in writings from ancient cultures. Hippocrates first provided a medical interpretation. In 1770, Tissot published Traité de l'épilepsie, a milestone in epileptology, whereas the 19th century is considered the golden era of epileptic studies. In 1882, the father of modern epileptology, Jackson, in his article Localized Convulsions from Tumour of the Brain, reported a case of a patient affected by typical Jacksonian seizures in the presence of a brain tumor. However, he did not establish a direct correlation between brain tumors and epilepsy, and an explanation for his clinical case was lacking. Before Jackson's article, other authors reported similar cases, but only Gairdner in 1834 published a report suggesting the concept of a direct relationship between epilepsy and a brain tumor. From the beginning until the mid of the 20th century several authors reported seizures attributed to intracranial tumors, and in recent years studies have focused on the pathogenesis of tumor-related seizures. Biochemical and molecular changes in brain tumors and their environment opened unprecedented working hypotheses on epileptogenesis and on treatment of epilepsy associated with brain tumors.

Epilepsy as a key feature in two works of fantastic literature by Alfred Kubin and Hermann Weyl: With a brief review of epilepsy in fantastic literature.

Among the many literary works of all styles and types referring to epilepsy, fantastic literature forms a distinct and interesting subgroup. The article draws attention to two such works belonging to early 20th century German avant-garde where epilepsy is a key feature. Of the authors, Austrian Alfred Kubin (1877-1959) was a renowned artist and illustrator whose only published (and illustrated) novel "The Other Side" (1909) can be understood as the narrative of a complex epileptic experience, perhaps a dreamy state. Of the other author, Hermann Weyl (1893-1960), very little is known. He was a Jewish neuropsychiatrist who emigrated from Nazist Germany to Argentina in 1933. His only published literary work, the novella "The Epileptic" (1927), displays high literary ambitions. The topic epilepsy provided for him the desired access to the fantastic realm, and his professionality enabled him to address with great expertise aspects as diverse as postictal psychosis and social stigmatization. Both works are, thus, valuable contributions to the tradition of epilepsy in fantastic literature. A brief review of the latter includes Edgar Allan Poe, Victor Hugo, Charles Dickens, Gustav Meyrink, Mervin Peake, Russell Hoban, Eraldo Baldini, Haruki Murakami, Adam Fawer, and Christoph Ransmayr.

Ceasing Antiquated Conceptions: A Telling of the Early and Evolving History of Epilepsy.

The word epilepsy is derived from the Greek word epilambanein, meaning "to seize." This term came to embody the disease as early descriptions characterized seizures as events in which the faculties of the mind and body were "seized" from the individual. This notion of seizing the mind and body's faculties has in essence remained a constant throughout the evolution of epilepsy. The theories elucidating the significance of the event, however, have surely shifted with the times, reflecting an elegant battle among magic, science, and theology. Subsequent advents in clinical observation, diagnostic evaluation, and therapeutics unfurled many mysteries of the brain and revolutionized prevailing theories, landing epilepsy as it is known today far beyond the primitive and highly supernatural notions that predominated in antiquity.

Psychosurgery in the History of Stereotactic Functional Neurosurgery.

The paper invites to reappraise the role of psychosurgery for and within the development of functional stereotactic neurosurgery. It highlights the significant and long-lived role of stereotactic neurosurgery in the treatment of severe and chronic mental disorders. Stereotactic neurosurgery developed out of psychosurgery. It was leucotomy for psychiatric disorders and chronic pain that paved the way for stereotactic dorsomedial thalamotomy in these indications and subsequently for stereotactic surgery in epilepsy and movement disorders. Through the 1960s stereotactic psychosurgery continued to progress in silence. Due to the increased applications of stereotactic surgery in psychiatric indications, psychosurgery's renaissance was proclaimed in the early 1970s. At the same time, however, a public fearing mind control started to discredit all functional neurosurgery for mental disorders, including stereotactic procedures. In writing its own history, stereotactic neurosurgery's identity as a neuropsychiatric discipline became subsequently increasingly redefined as principally a sort of "surgical neurology," cut off from its psychiatric origin.

Hysteria or epilepsy?

Hysteria and epilepsy have long been compounded by the term "hysteria-epilepsy" among neurologists and physchiatrists, including Jean Martin Charcot. In a 114 page unpublished manuscript written circa 1815, Jean-Baptiste Louyer Villermay, French physician and student of Philippe Pinel, considered the signs that would differentiate hysteria from epilepsy. This differential diagnosis approach was proposed long before Charcot's lecture in 1868 at Salpêtrière hospital.

History and Evolution of Epilepsy Surgery

The surgical treatment for epilepsy has a worldwide historical relevance for centuries. There are archaeological reports that date it back to ancient Egypt; however, the year 1886 is considered a landmark in the surgical treatment for epilepsy in theModern Age, when the first surgery for the treatment of focal epileptic events was performed successfully. Since then, innumerable related articles have been published evoluonarily. Over the last centuries, new techniques and technologies provided better understanding, diagnosis and management for this disease. Thus, historical and evolutionary knowledge becomes important to let us better understand the current position of the surgery for epilepsy treatment and control.

30 years of second-generation antiseizure medications: impact and future perspectives.

Since 1989, 18 second-generation antiseizure medications have reached the market, resulting in a greatly increased range of treatment options for patients and prescribers. 30 years have passed and now is the time for an appraisal of the effect of these medications on clinical outcomes. Every antiseizure medication needs to be assessed individually, but overall second-generation drugs are less likely to cause pharmacokinetic interactions than their older counterparts. Some second-generation antiseizure medications have shown advantages in tolerability and safety, particularly in the treatment of older patients and women of childbearing potential. Disappointingly, however, none of these medications appear to be more efficacious than first-generation antiseizure medications, highlighting the need for novel strategies in epilepsy drug development. Although second-generation antiseizure medications have not substantially reduced the proportion of patients with pharmacoresistant epilepsy, their availability has enabled more opportunities to tailor treatment choice to the characteristics of the individual.

Epilepsy over the centuries: a disease survived at the time.

In this study, we have made a historical review of epilepsy through the centuries, from pre-Christian era to the present time. The epileptic was examined by Hippocrates, the first to recognize epilepsy as a disease and not as a supernatural manifestation called Morbus Sacer. The dark years of the Middle Ages were the worst for the disease, where the sufferer was even subjected to torture. The period of the Renaissance saw the epileptic isolated from society while the Enlightenment century improved the knowledge about the disease, thanks also to the first autopsies that showed post traumatic neurological lesions. However, some stigmata of the disease that prevented the marriage of epileptics persisted. It was the prelude to the years 1800-1900, characterized by Lombrosian concepts and Nazi convictions. Lombroso included epileptics among delinquents and criminals, identifying them as such on the basis of physical alterations. Nazi racism introduced the concept of eugenics excluding the epileptic from the so-called pure race. Today, epilepsy is considered a treatable neurological disorder. Morbus Sacer belongs to a remote past.

Uterine epilepsy: a historical report from Avicenna's point of view.

OBJECTIVE: Epilepsy is a common neurological disorder, the history of which dates back to thousands of years ago. Avicenna (980-1037 AD) is a famous Persian scholar who considered different types of epilepsy and their specific treatments. His book Al-Qanun fi al-Tibb was taught in Europe for several years. Along with explaining the diseases occurring in various body organs, the book describes neurological and neuropsychological conditions such as epilepsy METHODS: This article is a review of the book Al-Qanun fi al-Tibb and some of the traditional Persian medicine sources, including Kamil al-Sinaa al Tibbiya and Makhzan-O-L Advieh, on uterine epilepsy, its etiology, clinical manifestations and treatments. Also, articles related to this topic in the field of traditional Persian medicine or historical articles have been searched for in Google Scholar search engine or PubMed database. RESULTS: Avicenna categorizes the causes of epilepsy into two main groups: those caused by brain diseases and those associated with the diseases of other organs. He believed that the stomach, the spleen, the maraqq, the uterus, or other body organs influence the brain and can cause epilepsy. In uterine epilepsy, the primary pathology lies with the uterus and can affect the brain. This condition occurs due to the retention of the menses or semen. CONCLUSION: In this historical article, we intend to explain Avicenna's viewpoint on uterine epilepsy. We suggest further studies on this topic, for example, to evaluate the frequency of epilepsy in patients with the retention of the menses or the semen.

Did Prophet Mohammad (PBUH) have epilepsy? A neurological analysis.

INTRODUCTION: The Prophet of Islam is one of the several famous religious figures who allegedly suffered from epilepsy. Early Greek chronicler Theophanes was one of the first to mention that the revelations of The Prophet were episodes of epilepsy, sparking a debate that has continued to date. This argument, for the most part, was confined to historic literary writings only until it was quoted by some eminent neurologists of recent times. They suggested probable diagnosis of temporal lobe epilepsy, adding credibility to the historical claims. MATERIAL AND METHOD: Review of works of some prominent historians, orientalists, literati from previous twelve centuries, and recent neurologists who believed The Prophet to be epileptic was done. The resource material that influenced them to believe this was likewise examined. Other archived literature including Hadith, the primary resource material that provides detailed information about the day-to-day happenings in The Prophet's life with books on the life of The Prophet by orientalists and Muslim historians describing such features during revelations and other events, was scrutinized. Documentations of these events from all resources were compared and analyzed from a neurological perspective. RESULTS: The author on analysis found literature indicating faulty translations of the original Arabic text into Latin as one of the reason for misleading conclusions. Verbatim translations of Arabic phrases used symbolically have taken away the exact construal giving it a wrong perspective. Similarly, The Prophet's peri-revelation episodes as they appear in Hadith when evaluated from a neurological perspective suggest that The Prophet did not have epilepsy. CONCLUSION: A judicious analysis of the features on which the historians and literati based their suspicion to label The Prophet epileptic, provides little supportive evidence when analyzed from a neurological perspective. Without judicious analysis of clinical data chances of misdiagnosis tend to be fairly high.

Margiad Evans (1909-1958): A writer's epileptic experiences and their reflections in her work.

Margiad Evans, in the period 1930-1950, an acclaimed English writer, developed convulsive seizures at age 41 and died at age 50 from the tumor that had caused them. In her book "A Ray of Darkness", she describes in profound analytic detail her seizure experiences, especially the isolated auras that had preceded her first convulsion by many years. Their ultimate strangeness echoed a long-standing fascination by the indescribable, which is a recurrent theme in her literary work. Another aspect of her poetry, a focus on the experience of the moment that cannot be retained is likewise reminiscent of the volatility of her aura experiences. Of three texts that are presently being published posthumously, one ("The Nightingale Silenced") is a fragmentary continuation of her epileptic experience. She considered that she still had a lot to describe, contributing the inside of the "outside inside story" of epilepsy, clues on which neurology could work to obtain a deeper understanding. To have a focal motor seizure feels like being invaded by an alien force. An urge to run and heautoscopy are other recorded symptoms. Evans documents the experience of a long-lasting, predominantly nonconvulsive status epilepticus merging into aura continua where her earlier aura experiences appear transformed into a quasipsychotic state. But even in the account of "this appalling, this hellish condition", she is careful to maintain her high literary standards. Together, the two reports on her disease seem to represent the only comprehensive inside case history of epilepsy, a most valuable legacy.

The earliest experimental convulsions by Joseph Priestley in 1766 friendship with Benjamin Franklin.

In 1766, Joseph Priestley (1733-1804) was the first to systematically demonstrate the universal convulsive effect of an electrical discharge applied to the head of all the several species studied. We here republish his overlooked experiments, which often resulted in death, and which ante date the scientific studies of the electrical functions of the brain, the role of "discharges" in seizures, and experimental epilepsy by about a century. Priestley's studies of electricity were influenced by those of Benjamin Franklin (1706-1790), who became a good friend during Franklin's prolonged period in London between 1757 and 1775. Both were elected Fellows of the Royal Society and both were awarded the Copley Medal of that Society. Priestley's experiments are relevant to the history of epilepsy and neuropsychiatry, and to the modern study of sudden unexplained death in epilepsy (SUDEP).