Abstract
i. credit for the first full clinical description of that fascinating subtype of epileptic fit called the complex partial seizure is regularly assigned to John hughlings-Jackson (1835-1911) on the basis of papers he published in english medical journals from 1875 to the turn of the century. 1 hughlings-Jackson himself, punctilious to a fault about acknowledging his predecessors, noted that certain other clinicians, especially French students of epilepsy, had partially anticipated his insights regarding complex partial fits. 2 But there can be little question that, particularly in the Anglophone literature, his studies of the entire spectrum of complex partial phenomena were pioneering efforts, and indeed, as works of clinical description, they remain unmatched today. We remain indebted to hughlings-Jackson, justly regarded as one of the founding spirits of english neurology, for the comprehensiveness and sensitivity with which he studied the objective but especially the psychologically rich subjective aspects of the partial aura (the introduc- tory phase of the seizure, the details of which the patient can frequently retrieve after the fact and disclose to others). these subjective experi- ences can include extraordinary distortions of time and memory such as deja vu, of emotion, and of consciousness, including a phenomenon famously christened by hughlings-Jackson as the dreamy state. the latter involves a condition of bifurcated or (to use the clinician's own term) double consciousness in which the patient during the fit at- tends simultaneously to a complex hallucinated scene and to his ac- tual environs, generally discriminating the two and maintaining some
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