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The Meaning of Jacksonian Epilepsy

Max Levin, MD
JAMA. 1965;191(12):1033. doi:10.1001/jama.1965.03080120067030.
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To the Editor:—  The editorial on John Hughlings Jackson (JAMA189:692 [Aug 31] 1964) calls for two comments.

  1. The editorial says that Jacksonian epilepsy "is characterized by progression of local spasm, usually unilateral, with retention of consciousness." I believe the intended meaning is correct, but the reader may find the statement ambiguous. The Jacksonian seizure always starts with unilateral spasm. The spasm may progress to become bilateral. Consciousness may be lost, but, if so, it is late in the seizure, never at the start.

  2. The editorial says that "Jackson preferred the term 'cortical epilepsy'...." for what we today speak of as Jacksonian epilepsy. The truth is quite to the contrary: Jackson objected to this term. Thus he wrote (Selected Writings of John Hughlings Jackson, vol 1, 415): "I do not use the term 'cortical epilepsy,' because both epileptic and epileptiform seizures are, to my thinking, cortical fits."


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