The operative treatment of Jacksonian and focal epilepsy / by Charles Beylard Nancrede.

  • Nancrede, Charles B. (Charles Beylard), 1847-1921.
Date:
1896
Catalogue details

Licence: Public Domain Mark

Credit: The operative treatment of Jacksonian and focal epilepsy / by Charles Beylard Nancrede. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    icpA • j/ . •' jgr THE OPERATIVE TREATMENT OF JACKSONIAN AND FOCAL EPILEPSY.1 By CHARLES BEYLARD NANCREDE, M.D.,1 OF ANN ARBOR, PROFESSOR OF SURGERY IN THE UNIVERSITY OF MICHIGAN. WHEN Hughlings Jackson, about ten years ago, suggested the removal of the discharging lesion for epilepsies, if the spasms began “ very locally, developed deliberately, and when the fits are often repeated,” the idea was promptly accepted, and soon the bulk of the profession and the laity viewed this operation as the only proper course to pursue at any stage of, or in any form of epilepsy, where the merest suggestion of a discharging lesion could be detected. Moreover, if the patient survived the operation, permanent recovery was confidently ex- pected. The pendulum soon began to swing in the opposite direction, and because permanency of results cannot be assured, the prolonged immunity from seizures commonly conferred by such operations seems to be becoming considered as not worth having. This is unscientific, and if operators would publish their “ end-results,” I believe the proper place of trephining as a thera- peutic measure would soon be ascertained, and possibly better results secured. D. Hayes Agnew, in 1891, called attention to the lack of permanency in results, confining his attention to cases operated upon by Philadelphia surgeons, and gives in his list a case of mine as cured,—i.e., it had remained free from recurrence for three years. I shall give an abstract of the history of this case, when the reader can decide for himself whether even this patient was cured. I shall make as few comments as possible upon my illustra- tive cases, permitting the histories to speak for themselves, em- phasizing merely those points which seem to me especially worthy of notice.