Case of idiopathic epilepsy observed which developed in the eightieth year of life. Frederick T. Simpson (Jour. of Nerv. and Mental Dis., Jan., '96).
According to the same table females show a somewhat greater predisposition to the disease than males (females, 54.6 per cent.; males, 46.4). This relative dif ference is really greater than is indicated by these figures, if we take into consider ation the greater exposure in males to cranial and other accidents, which are frequent causes of epilepsy. The occu pation is often a side-light upon the eti ology. Epilepsy in sailors or prostitutes suggests syphilis; liquor-selling suggests alcoholism; painting and plumbing sug gest lead as a cause.
Alcoholism in its acute and chronic form may become an important etiolog ical factor of epilepsy. The nutritive exchange of the cells in an organism saturated with alcohol is impaired. The normal vital activity of the plasmic unit, its inherent ability to effect chem ical change, is partly or totally sus pended, is paralyzed, if physiologically, and poisoned, if chemically viewed. Heinrich Stern (N. Y. Med. News, Sept. 18, '97).
Alcoholic epilepsy is divisible into three classes: (1) the convulsive and maniacal type, (2) dementia and con fusional states, and (3) automatic trance and psychical eases. Hereditary tend encies and predispositions, together with condition of the patient's health, are recognized as factors in varying the type of the disease. Reference made to the development of the delusional states among epileptics, the common manifesta tions being fear of death or injury, which is usually but temporary. Cases reported illustrating each of the three forms of the disease, and, as a sequence of the first mentioned, pnemnoparesis; of the second, cerebral Ivemorrhages and nephritis; while epileptic convulsions were more common in the third. Homi chic and suicide are more frequent in the former two classes. Reference made to the increase of alcoholic epilepsy, which is considered to be due to the change in the character of the spirits used over those employed in former years, wood alcohol being believed to be monk the notable constituents in the newer mixed drinks. For the treatment of these cases total abstinence, nerve and brain rest, sharp elimination, re stricted diet, and a radical change in business and surroundings are thought to he the most efficient methods. (T. D.
l'rothers.) There is probably no distinct form of epilepsy that could be properly called epilepsy." The author is rather inclined to look upon alcohol as one of a class of a number of causative agents of this condition, and he also ex pressed the opinion that it was quite as likely that the epilepsy acts as a cause of the patient becoming an inebriate. It was thought well to confine the classifi cation of these conditions to as few headings as possible, as too large a va riety of names for the same disease would be apt to lead to confusion. (J. H. Lloyd. ) A great many of these attacks due to an acute congestion of the brain. Case of a man referred to who during the re cent warm spell was seized with an at tack of typical epilepsy. When seen by the author he was suffering from his fourth convulsion; venesection was promptly performed, and in a few days the patient was apparently . (F. Savary Pearce.) Proceedings of the American Medical Association (New York Med. Jour., June 14, 1902).
Certain diseases tend to develop an in stability of the nervous system, and thus predispose the subject to the subsequent development of epilepsy.
Epidemic and sporadic cerebrospinal meningitis, insolation, scarlet fever, typhoid fever, and other kindred dis eases, if attended with prolonged high temperature or toxemia, may lead to the development of epilepsy, the relationship being apparently one of cause and effect.
Disease of the heart or blood-vessels interfering with the circulation in the brain and its nutrition is properly re garded, we think, as a sufficient explana tion of the etiology in certain cases of cardiac and so-called senile epilepsy, and perhaps in other obscure cases. With re gard to the organic and toxic epilepsies, the etiology and pathology is that of the primary organic disease, the epilepsy in such cases appearing only as a single, though sometimes the most important, symptom. Any source or irritation within the cranial cavity, whether chem ical or mechanical, may—though it by no means must—induce a convulsion.