In accordance with his views on duplex symptomatology, Hughlings Jackson maintained that one may distinguish in the state of a patient after an epileptic fit two elements: (1) a negative element, due to the exhaustion of the highest centers, and (2) a positive element, represented by the activity of intact lower centers, this activity being permitted by the suspension of the control normally exercised by the highest centers. In Jackson's words, "there is (1) loss of control permitting (2) increased automatic action" [I, 123].1
There is a relationship between the severity of the fit and the degree of subsequent disability and the complexity of such automatic behavior as may occur. The severest fit is followed by a complete suspension of activity save for the persistence of circulation and respiration. Here the dissolution is deep and the disability great, while the actions permitted are the least complex. On the other
Levin M. ELABORATE MENTAL STATES AFTER SLIGHT EPILEPTIC PAROXYSMS. Arch NeurPsych. 1934;32(2):397–400. doi:10.1001/archneurpsyc.1934.02250080143009
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