Neurology was there in 1948.
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Biomedical subjects
Publications and source records attributed to F M Forster.
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Patients with seizures accompanied by generalized cortical electrodecremental event (CEE) have clusters of clinical spells with tonic, dystonic, or atonic components and involvement of autonomic functions. When electroencephalographically detectable foci are present, they behave in a peculiar way; throughout the entire cluster of seizures focal spiking is reduced in the short interictal periods as well as during each individual seizure with CEE, at which time it is suppressed. Focal firing reappears reinforced at the end of each spell and also at the end of the cluster. These facts suggest that the foci responsible for CEE are deeply located. A complex excitatory-inhibitory feedback probably exists between cortical and subcortical foci. These seizures should be differentiated from similar attacks of nonepileptic or epileptic nature. A correct diagnosis is essential given the different therapeutic implications.
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Hyperventilation evoked abnormal EEG discharges or discharges and clinical seizures in 11% our patients with partial complex seizures. Hyperventilation is useful in the diagnosis of this kind of epilepsy, but may need to be pursed more vigorously and for a longer duration than is usual practice. The vigorous use of hyperventilation in selected patients with partial seizures should be employed before the use of other more complicated, expensive, and potentially harmful activating procedures.
A patient had seizures while playing chess or cards or when filling out complex forms, doing complex mathematical problems, and during certain parts of the neuropsychological testing. Seizures were myoclonic and accompanied and electroencephalographic dysrhythmia of the atypical spike and wave type. Evoked seizures were not related to visual, tactile, or auditory stimuli or clues. In chess, seizures occurred when he was on the defense and threatened. Simple decision making or physiologic stress did not evoke seizures nor did nonsequential decision making under verbal pressure. Evoking factors were complex decision making in a sequential fashion and with an element of stress or concern regarding the outcome of the decision making. Stimulus was usually nonverbal. Three major factors--decision complexity, sequential factor, and related stress or concern--may have some reciprocal relationships.
Primary reading epilepsy was diagnosed by special electroencephalographic (EEG) studies in an adolescent youth after his first grand mal seizure. Similar studies of members in three generations of his family showed primary reading epilepsy in his first cousin and in two of his siblings. The disorder in the siblings had not been noticed by parents or teachers and probably would have remained undetected without the use of special techniques. This pedigree buttresses other reported evidence for autosomal dominant transmission of reading epilepsy. The centrencephalic EEG trait also is present in some members of this family. The possible inplications of this association are discussed.
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