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July 1934

AUTONOMIC EPILEPSYReport of a Case with Observations at Necropsy

Author Affiliations

Portland, Ore.

Arch NeurPsych. 1934;32(1):189-197. doi:10.1001/archneurpsyc.1934.02250070195012

In 1929, Penfield1 introduced the conception of autonomic epilepsy, reporting in detail the history and observations at necropsy in the case of a patient with a cholesteatomatous tumor of the choroid plexus of the anterior part of the third ventricle, intermittently blocking the foramina of Monro as a ball valve and producing focal degenerations in the rostral part of the thalamus above the anterior commissure. The floor and the lower lateral walls of the third ventricle were not demonstrably affected; there was relatively wide bilateral communication between the knees of the lateral ventricles and the circumpineal arachnoid spaces. During the repeated attacks the sequence was: a prodromal sense of warmth and thirst, with sudden dilatation of the capillaries of the skin in areas supplied by the cervical sympathetic and a precipitate rise in blood pressure; this was followed by marked lacrimation, sweating, salivation, pupillary movements, exophthalmos, billowing pilomotor excitation,