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History of Epilepsy Surgery

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History of Epilepsy Surgery eCommons@AKU Section of Neurosurgery Department of Surgery 4-2007 History of epilepsy surgery Ather Enam Aga Khan University, [email protected] Follow this and additional works at: https://ecommons.aku.edu/pakistan_fhs_mc_surg_neurosurg Part of the Neurology Commons, Neurosurgery Commons, and the Surgery Commons Recommended Citation Enam, A. (2007). History of epilepsy surgery. Pakistan Journal of Neurological Sciences, 2(2), 129-129. Available at: https://ecommons.aku.edu/pakistan_fhs_mc_surg_neurosurg/78 V I G N E T T E HISTORY OF EPILEPSY SURGERY S. Ather Enam Aga Khan University The history of epilepsy surgery is as old Unfortunately he could not as the roots of modern neurosurgery. fulfill his dream but did build a Surgical intervention to cure epilepsy neurosurgical department of can be traced back to occasional distinction at that institution. reports from France and England of relief of post-traumatic epilepsy by The duo that eventually brought trephination in the early 19th century. epilepsy surgery to the Trained among these European knowledge of common people surgeons, the American Benjamin was Wilder Penfield and Benjamin Winslow Winslow Dudley (1785-1870; left) at Herbert Jasper. Penfield Dudley Transylvania Medical School in (1891-1976), born in Lexington, Kentucky, was the first one to publish a series of Spokane, Washington, was reports of trephination for post-traumatic epilepsy. Four out initially not interested in L tp R: Percival Bailey, of five patients were relieved of their seizures. A success of medicine as he saw his father Erna and Frederick Gibbs almost 80% is very impressive especially considering the fail in his medical practice fact that this was a pre-Listerian and pre-anesthesia era. which eventually led to the divorce of his parents. His These must have been very carefully selected cases. Dudley mother had a strong influence on him. His professional was an interesting man; he fought a duel with a surgical thinking about neuroscience and neurosurgery was colleague, and then carried his opponent to the hospital to influenced by Sir Charles Sherrington and Sir William Osler remove his bullet from the wound he inflicted. at Oxford, and later by Harvey Cushing at the In the late nineteenth century Victor Horsley, a general Peter Bent Brigham surgeon by training but with a tremendous interest in Hospital in Boston. neurosurgery (considered one of the fathers of This combination of neurosurgery) reported three craniotomies for focal motor n e u r o s c i e n t i s t s seizures that he did (Sherrington and on the behest of Osler) and a Hughling Jackson Wilder Penfield Herbert Jasper n e u r o s u r g e o n (epileptologist who (Cushing) influencing described Jacksonian the same mind was a very potent one. This eventually epilepsy). Two of resulted in Penfield (and William Cone) establishing the these patients world-class Montreal Neurological Institute. Herbert Jasper improved. The pair of (1906-1999) was born in Oregon and came to Canada in Hughling Jackson Victor Horsley Horsley and Jackson 1938 to build his career at Montreal Neurological Institute produced milestones as an epileptologist. Penfield and Jasper published a in the history of neurosurgery. These included operations on landmark book Epilepsy and the Functional Anatomy of the motor cortex, removal of tumor compressing the spinal Human Brain in 1954. cord, and so on. While this was going on in Europe, two epileptologists Frederick and Erna Gibbs at the University of Interestingly, after this initial excitement, surgical treatment Chicago worked with Percival Bailey to perform temporal for epilepsy went out of favor for several decades until it was lobectomy on patients who were diagnosed to have brought into mainstream neurosurgery once again in the temporal lobe seizures. Percival Bailey also had a strong 1980s by neurosurgeons in the United States. Although influence from European surgeons. He obtained his MD medical management of epilepsy has made huge progress from University of Chicago, got interested in neuroanatomy since the armamentarium of medications available to the and got a PhD from Northwestern University before neurologist has quadrupled, advancement in surgical embarking on surgical training. He returned to University of technology has concurrently placed epilepsy surgery as a Chicago with a dream to build a neuroscience center. mainstay in the treatment of epilepsy. PAKISTAN JOURNAL OF NEUROLOGICAL SCIENCES 129 VOL. 2(2) APR - JUN 2007.
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