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April 1923

THE PATHOGENESIS OF EPILEPSY: A CRITICAL REVIEW WITH A NEW INTERPRETATION OF THE AVAILABLE DATA

Author Affiliations

Associate Professor of Neurology, New York Post Graduate Hospital and Medical School; Associate in Neurology, Columbia University NEW YORK

Arch NeurPsych. 1923;9(4):488-505. doi:10.1001/archneurpsyc.1923.02190220074007
Abstract

The conceptions of the causes of epilepsy are many and confusing. Any discovery which reveals the causes underlying the convulsive manifestations will tend to clarify the situation. I have little sympathy with the view so often expressed of late that the mental (dementia), and even the paralytic and other somatic disorders of epilepsy, are secondary to the psychogenically determined convulsive attacks. The more I study the experimental work and the anatomic, biochemical and pathologic data bearing on the question, the more tenaciously do I hold to the belief that if the convulsions in epilepsy are once satisfactorily explained, the whole problem will be placed on a sound basis.

While it is not possible to synthesize all theories of the causation of epilepsy, the psychogenic factor may be readily assimilated in our discussion. The staunchest upholder of the psychanalytic conception is Dr. L. Pierce Clark.1 He believes that epilepsy is

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