Experience with a fairly large number of epileptic patients shows striking differences among them. There are vital differences not only as to etiology (Cobb1) but also as to the manner in which the illness sets in, its evolution and its clinical manifestations. In fully developed epilepsy the attacks usually show an assortment of features, including psychic, visceral and motor symptoms.
In this study we directed attention to the mode of onset and noted that the illness commonly began in one of two ways. In some patients epilepsy set in abruptly; a person previously well fell to the ground in a sudden, violent convulsion. In other patients the disease set in gradually, beginning with slight, peculiar sensations, which recurred with added features until, in the course of months or years, true epileptic characteristics became evident. The first type may be considered as abrupt or violent; the second may be designated
FETTERMAN JL, HALL VR. MODE OF ONSET OF EPILEPSY. Arch NeurPsych. 1937;38(4):744–755. doi:10.1001/archneurpsyc.1937.02260220088004
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