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In the discussion of the operative procedure of epilepsy, one very important fact has failed to command the attention it deserves. Because an epileptic seizure is localized in its onset and course, it by no means argues that the epileptic lesion is a gross one or one to be benefited by operative procedure. We may have non-traumatic partial epilepsy, or what has been described by Fere as parcellar epilepsy or monospasm. These partial epilepsies may, and generally do, tally with grand mal fits in all other respects aside from their peculiar muscular spasm.
Again, because the epileptic fit has a leisurely and well-marked order of invasion in the convulsion, it does not necessarily prove that a focal disease is at the beginning of the fit. Many grand mal epileptics, apparently idiopathics, come to autopsy with no visible local cause for this systematic order of invasion. Even various forms of localized
THE LIMITATION OF OPERATIVE TREATMENT OF EPILEPSY. JAMA. 1898;XXXI(21):1251–1252. doi:10.1001/jama.1898.02450210053009
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