. Epilepsy, a study of the idiopathic disease. uency of the attacks varies as much as the grand malseizures, from several in the course of the month up to eight orten daily. As in the major variety, there is a certain constancy of typeobserved throughout the course of the malady. As time goeson, a tendency to increase of frequency of the seizures may benoted. On the other hand, the minor type, when established,rarely, if ever, changes into the major variety; major fitsmay ensue later in the course of the disease, but the minorattacks do not disappear, nor are they replaced by the grandmal seiz
. Epilepsy, a study of the idiopathic disease. uency of the attacks varies as much as the grand malseizures, from several in the course of the month up to eight orten daily. As in the major variety, there is a certain constancy of typeobserved throughout the course of the malady. As time goeson, a tendency to increase of frequency of the seizures may benoted. On the other hand, the minor type, when established,rarely, if ever, changes into the major variety; major fitsmay ensue later in the course of the disease, but the minorattacks do not disappear, nor are they replaced by the grandmal seizures, the change being from the minor type into thecombined form with the minor seizures in excess. A characteristic instance of this form of the disease is illus-trated in Chart 4, which depicts a severe type of minorepilepsy. The seizures consisted of a sudden fall withmomentary loss of consciousness, followed by instant recovery. CHART 2. A Severe Type of Major Epilepsy. JAN. MAR. APRIL MAY JUNE JULY AUG. OCT. NOV, 62 84 74 46 ff.£ S. £din THE COMBINED TYPE 97 As the year advanced the falls increased rapidly in number,until a condition of status epilepticus ensued on Nov. patient eventually developed delusional insanity, and wasremoved to an asylum. The mental attitude of the minor type is more characteristicthan in the major type. The usual psychical state consists ofa slight degree of mental impairment, chiefly loss of memory,more particularly for recent events. It is rare to find examplesof this type with a normal mental state: on the other hand,profound degrees of dementia are less common than in theother groups. The rarity of the pure type of minor epilepsy is remarkable ;it occurs, moreover, in persons endowed with high intellectualabilities. 3. The Combined Type. This is a common type of epilepsy, being found in 382per cent, of the cases examined. It occurs in three varieties. (a) Major attacks in excess of minor. (h)
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