Lewis Carroll's personality and the possibility of epilepsy.

Lewis Carroll's classic Alice in Wonderland describes Alice's fantastical experiences so similarly to the actual phenomenology of the eponymous syndrome, that it has been previously suggested that Carroll himself experienced it. The syndrome is mostly associated with migrainous aura, and naturally, Carroll was postmortemly "diagnosed" as a migraineur. However, when considering his unique personality profile, it appears that he might have had temporal lobe epilepsy.

[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.

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.

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.

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.

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.

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).

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.

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.

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.

Intelligence and epilepsy: The early era.

This contribution to the commemoration of the 20th anniversary of Epilepsy & Behavior addresses the topic of epilepsy and intelligence, an early focus of interest in the history of the neuropsychology of epilepsy. The path through which the earliest measures of intelligence found their way to epilepsy research is reviewed followed by an overview of the subsequent themes of research, points of disagreement, advances in research using measures of intelligence, and developing awareness of the limitations associated with reliance on intelligence tests. Special Issue: Epilepsy & Behavior's 20th Anniversary.

History of dietary treatment: Guelpa & Marie first report of intermittent fasting for epilepsy in 1911.

We analyzed the article of Guelpa & Marie, published in 1911 and often quoted in the history of dietary treatment, as the basis for the use of ketogenic diet to mimic fasting. In this paper, the authors treated 21 patients with a diet consisting of daily administration of 30 g of sodium sulphate for 4 days, with unlimited aqueous beverage and no food, followed by a vegetarian diet restricted to half of the ordinary intake. This is the first report of intermittent fasting as treatment strategy for epilepsy. In this case series, 15 patients did not follow properly the diet while 2 improved temporary before they quitted the diet and 4 presented an improvement.

Psychoanalytical concepts of epilepsy.

As part of the anniversary issue of Epilepsy & Behavior looking back as aspects of the history of epilepsy, this article reviews psychoanalytical concepts of the pathogenesis of seizures and the so-called epileptic personality (epileptic constitution). It addresses the question whether these theories are completely invalid or do they have insights that are worth rediscovering. Special Issue: Epilepsy & Behavior's 20th Anniversary.

Madness, Medicine and Miracle in Twelfth-Century England.

This monograph provides a fresh perspective on how madness was defined and diagnosed as a condition of the mind in the Middle Ages and what effects it was thought to have on sufferers. Records of miracles that were believed to have been performed by saints reveal details of illnesses and injuries that afflicted medieval people. In the twelfth century, such records became increasingly medicalized and naturalized as the monks who recorded them gained access to Greek and Arabic medical material, newly translated into Latin. Nonetheless, by exploring nuances and patterns across the cults of five English saints, this book shows that hagiographical representations of madness were shaped as much by the individual circumstances of their recording as they were by new medical and theological standards.

Epilepsy in Hildegard of Bingen's writings: A comprehensive overview.

Hildegard of Bingen (1098-1179AD) is one of the most relevant figures of the Middle Ages. She wrote two medical books, Physica (Natural history) and Causae et curae (Causes and remedies). Our aim was to provide a comprehensive account of Hildegard of Bingen's conception of epilepsy, of the remedies proposed to treat it, and of the medical and physiological theories behind their use. We searched Hildegard of Bingen's entire body of writings to identify any possible reference to epilepsy or epileptic seizures. We reported the identified passages referring to epilepsy and discussed their content in light of medieval medical and physiological theories. Most references to epilepsy were found in Physica and Causae et curae. The suggested remedies against epilepsy range from herbal preparations to animal remedies and jewel therapy. Hildegard's conception of epilepsy gives the impression of an original revisitation of the traditional theory of humors, and carries strong moral connotations. Hildegard of Bingen's conception of epilepsy appears strongly rooted in medieval thinking and less in physiological theories. However, it differs in many respects to the traditional medieval beliefs and is a further proof of her unique personality. As living testimony of the past, Hildegard's writings enable us to shed a fascinating light on the beliefs concerning epilepsy in the middle ages.

The Montreal procedure: The legacy of the great Wilder Penfield.

Wilder Penfield pioneered the early practice of brain surgery. In binding together the disciplines of neurosurgery, neurology, neuropathology, psychology, and related basic sciences, Penfield transformed our understanding of the field of neuroscience. He brought to the operating room the meticulous techniques of Sherrington, combined with methods of stimulation described by Foerster, which he complemented with expert knowledge of the neurocytology of nervous tissue. While developing surgical treatments for epilepsy, Penfield began to map the brain. He established the "Montreal procedure" for the surgical treatment of epilepsy. His scientific contributions on neurostimulation were transformative in their time and continue to resonate today. This article reviews the life of Wilder Penfield and summarizes key scientific contributions. Specifically, we detail the Montreal procedure. We additionally present a painting by Canadian artist Iris Hauser, which purports to display the hidden treasures of the human mind.

Peritoneum as an origin of epilepsy from the viewpoint of Avicenna.

There are studies that show that the concepts of epilepsy have been rooted in Persian medicine; Avicenna "Ibn-e-Sina"-one of the great Persian physicians in the Islamic golden age (9th-12th century AD)-has considered some types of epilepsy with the association of the stomach, the spleen, the "Maraqq," and the whole body which has not been reviewed properly. These organs influence on the brain and can cause epilepsy. This article presents concept of Maraqq-related epilepsy; according to Avicenna's view, "Maraqq" is a membranous structure which is located in the abdomen (equivalent of parietal peritoneum in current nomenclature). We discuss his viewpoint about the diagnosis and treatment of Maraqq-related epilepsy with focus on herbal remedies. The concept of a relationship between the "Maraqq" and the brain is well discussed in the old Persian medicine texts; however, it seems that further studies in this area are required to clarify Avicenna's view about the pathophysiological mechanisms, clinical manifestations, and treatment strategies.

Epilepsy in popular Medicine from the Classic Age to the Modern Age: a study on elk hoof as an original treatment.

European people believed that epilepsy was both a sacred and demoniac disease in the pre- and post-Hippocratic Age, and this belief continued into the Christian era. Epilepsy was wrapped in mystery. The present work shows an epileptic treatment using elk (Alces alces) hoof, which was better known among Northern European people, and explains its historical and popular origins that lead to its importance and success within the Official Medicine in the sixteenth and seventeenth centuries until its gradual decline as a specific treatment in the subsequent centuries. We study authors from both Antiquity and the Modern Age. The present work concludes by highlighting the relationship between epilepsy and its magic-religious inheritance. It could be considered a valid example showing how a popular treatment can earn honors in the Official Pharmacopoeia, but later be excluded.

'Infantile convulsions' in the early nineteenth century. Abnormal brain blood flow and leeches, teething and gums' scarification and food and purgatives: the historical contribution of John Clarke (1760-1815).

In this article, we discuss on the role of the British physician and midwifery practitioner John Clarke (1760-1815) in the characterisation of the various types of seizures and epilepsy and related phenomena ('convulsions') occurring in children. In his unfinished work Commentaries on Some of the Most Important Diseases of Children (1815), Clarke discussed the pathophysiology of convulsions and was the first to describe, 12 years before the French neurologist Louis Francois Bravais (1801-1843) and more than 30 years before the Irish-born physician Robert Bentley Todd (1809-1860), the postictal paresis. He believed that convulsions originated from changes in pressure within the ventricles as a consequence of abnormal blood flow to the cerebral vessels. In keeping with the theories of his time (e.g. Baumes 1789, 1805; Brachet 1824), Clarke believed that teething was a major cause of 'infantile convulsions'. His proposed remedies ranged from scarification of the gums to ammonia, application of leeches, cold water, and purgatives. The use of antispasmodics, quite popular at the time, was instead questioned. In his Practical Observations on the Convulsions of Infants (1826), the London practitioner and midwifery John North (1790-1873) deeply criticised Clarke's view that convulsions arise inevitably as a consequence of organic brain lesions. North inferred that the results of autopsies of children who had died of convulsions revealed no brain damages, and claimed that cerebral irritation could also occur as the effect of distant lesions. Other Clarke's contemporaries (e.g. Jean Baptiste Timothée Baumes-1756-1828) inferred that all convulsions reflected a hereditary diathesis, which rendered children (especially those with softer and limper nervous and muscular tissues!) extremely sensitive to all sorts of provocation that could trigger convulsions, including bad digestion (more pronounced at the time of teething), loud noise, and bright light. Although almost every aspect of Clarke's view on convulsions was subsequently proved wrong, his (and his contemporaries') work provides fascinating insights into the theories and therapies of seizures, which were popular at the dawn of modern neurology.