Embodying brainstorms: the experiential geographies of living with epilepsy

This paper examines how living with epilepsy involves the complex interaction of knowledge of the unstable body, surrounding space and social relations. Through an engagement with written testimonies, it is argued that the spatial extent of everyday life varies with willingness to take socio-emotional and material risks in terms of when and where losses of bodily control (‘seizures’) might occur. I suggest that spaces and activities once taken-for-granted become potentially ‘unsafe’ and require renegotiation as trust in the limits of the body is disrupted. Findings confirm but also build upon previous work by geographers of chronic illness and impairment by engaging characterisations of the temporalities of fluctuating symptoms and of illness as manifesting either visibly or invisibly. Furthermore, it is argued that how people respond to the complete loss of bodily control differs in key ways to people coping with partially impaired control of the body. The paper concludes by asserting the potential for using written testimony as source data to highlight the voices of people whose spaces may otherwise remain silent.     

The Idea of Epilepsy as a Disease Per Se

In the 1850s Delasiauve and Russell Reynolds independently introduced the idea that the previously more inclusive concept of “epilepsy” should be restricted to that of an idiopathic disease manifesting epileptic seizures not caused by detectable brain pathology. This idea was rather widely accepted, though with some modification, over much of the next century. However there was increasing opposition to the idea from those, including John Hughlings Jackson, who perceived that all epileptic seizures must be symptoms of underlying brain disease. With increasing identification of structural brain pathology in what had been regarded as instances of idiopathic epilepsy, the latter view has increasingly prevailed.     

Making Distinctions: The Contribution of Hector Landouzy to Differential Diagnosis in Relation to Hysteria and Epilepsy

Hector Landouzy (1818-1864) is known for his Traité Complet de l'Hystérie (1846), which was crowned by the Académie de Médecine, but this work is not given much importance in historical accounts. It deserves more attention because it was more than an orthodox statement about the nature of hysteria. In the context of the diagnostic confusion between epilepsy and hysteria, it introduced a method of presenting criteria to facilitate diagnosis. An examination of French authors on epilepsy and hysteria in the second half of the nineteenth century suggests that this method probably set the example which was to be followed by later clinicians, including Charcot at the Salpêtrière.     

Did Herbert Spencer Have Reading Epilepsy?

Herbert Spencer, the nineteenth-century philosopher, has frequently been dismissed as a “fantastical hypochondriac” (as his most recent biographer, Mark Francis, terms him). Yet he left a record in his Autobiography of symptoms that suggest a very different diagnosis. Abruptly at age 35, he found that the activity of reading, previously indulged in without difficulty, triggered paroxysmal episodes of disturbing “head-sensations” including “giddiness” (so Spencer described them); these severely curtailed his ability to carry out his philosophical studies. Of all possible explanations for such episodes, none seems as likely as reading epilepsy. Enduring preconceptions about Spencer's presumed neurosesmay have kept modern historians from appreciating that Spencer suffered from a legitimate, if esoteric, neurological malady.     

Ancient Indian concepts about phenomenology,biology, and therapeutics of epilepsy

This article discusses etiology, pathogenesis, symptoms, and treatment of epilepsy, as described in Charaka Samhitā (translation: Charaka’s Compendium) and Sushruta Samhitā, the two core texts of Ayurveda, an ancient system of medicine. Ayurveda emphasized amnesia and loss of consciousness as core features of epileptic seizures (Sanskrit: apasmar; translation: apa negation, smaran memory) and recognized that seizures occur due to a disturbance in brain function or flow of “humors” to the brain. Semiology of various seizure types was well described. Epilepsy was attributed to both internal and multiple exogenous factors. Treatment of epilepsy with formulations of naturally occurring substances, their compounding and use, is described in remarkable detail. Lifestyle modifications to protect people with epilepsy are also documented. Cognitive comorbidities of epilepsy were recognized. Although none of the Ayurveda formulations have any empirical evidence supporting their safety or efficacy in the treatment of epilepsy, studies are needed to generate relevant evidence, to recognize their hazards, and to integrate traditional and complementary systems of medicine with modern health care in an informed and safe manner.     

Samuel Tissot’s Traité de l’épilepsie—250 years old

A quarter of a millennium ago, Samuel Tissot (1728–1797), a Swiss physician who had achieved a substantial European reputation, authored a monograph entitled Traité de l’épilepsie. The book was translated into several European languages and appeared in various editions over the following 70 years, although an English-language version was never published. In his Traité, Tissot provided a thorough account and critical analysis of the previous relevant literature concerning epilepsy, added data from his own experience in practice, and raised issues, some of which remain important today. The appearance of the book was propitious, occurring during the period of the European Enlightenment, when medicine was increasingly divesting itself of ancient modes of thinking and veneration for the opinions of great names from the remote past. At least in Western Europe, the Traité de l’épilepsie became an intellectual launching pad for the considerable expansion in knowledge of epilepsy that occurred over the century or longer that followed its publication.     

Biological and Epistemological Models of Localization in the Nineteenth Century: From Gall to Charcot

In the latter half of the nineteenth century, the localizationist doctrines became closely associated with the memory trace paradigm. The analysis of the texts dealing with the localization and the nature of ‘the loss of articulated speech’ (motor aphasia) by Bouillaud, Lordat, Dax, Broca, Trousseau, Baillarger, Charcot and Wernicke shows how the biological paradigm of localization presented by Gall and based on the notion of organ-function correspondence was transformed into a model based on localizable memory traces. This change resulted in the theoretical unification of the mechanisms of motor and non-motor forms of aphasia. These forms, which the earlier authors tended to separate in their analyses of the underlying mechanisms, were now regarded as involving similar mechanisms related to the loss of mnestic images. The crucial step in this development was taken by Broca who presented the hypothesis that the faculty of coordination of speech movements, which according to his predecessors was the faculty lost in motor aphasia, was actually an intellectual faculty and a specific form of memory, and motor aphasia consequently a selective kind of amnesia. Theorists like Charcot and Wernicke generalized this idea into a comprehensive theory of the nature of localization based on the notion of memory traces. Thus, the localization of function was reduced to the localization of representations. Instead of biological paradigms, this model of localization is rooted in the epistemological tradition of psychology represented by Locke and Condillac, who were primarily interested in the problem of representation. In physiology, this approach usually resulted in attempts at localizing representations instead of functions.     

George Sigerson: Charcot's translator*

Abstract

Senator George Sigerson (1836–1925), Dublin's first neurologist, was also a significant contributor to Anglo‐Irish literature. His medical career and literary accomplishments are outlined, the focus of the article being Sigerson's friendly relationship with Charcot (with whom he corresponded), and whose Leçons sur les maladies du système nerveux he translated.