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To the Editor:
—I have read with a great deal of interest Dr. Reed's articles on epilepsy. His theory of an edema of the subcortical nerve tracts, accompanying or following a condition of general acidosis, which in turn results in some way from stasis of the bowel contents, seems to be a real step in the right direction.But it has occurred to me, as it doubtless has to others, that this fails to account for the symmetrical manifestations of the typical attack of epilepsy. A symmetrical edema of both internal capsules is of course possible, but shall we say it is probable?This theory would more nearly account for a typical attack of migraine, with its unilateral headache, hemianopsia, diplopia, paresis of the opposite extremities, and occasional motor aphasia in left hemicrania. Practically all migrainous patients are constipated, and practically all are relieved by large doses of sodium bicarbonate.
Strate LK. Constipation in Causation of Epilepsy and Migraine. JAMA. 1916;LXVI(9):675-676. doi:10.1001/jama.1916.02580350063035