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J. 休林斯·杰克逊关于癫痫的思想演变

The evolution of J. Hughlings Jackson's thought on epilepsy.

作者信息

Eadie M J

机构信息

Department of Medicine, University of Queensland, Brisbane.

出版信息

Clin Exp Neurol. 1990;27:29-41.

PMID:2129959
Abstract

By 1870, and within 5 or 6 years of his beginning to analyse the clinical phenomena of epilepsy and to correlate them with autopsy data, the 35-year-old John Hughlings Jackson had come to a view of the nature of epilepsy that was radically different from that of his contemporaries. He recognized that epileptic seizures arose in the cerebral cortex, and not in the medulla oblongata, as was then thought, and he saw that there was no fundamental difference between so-called 'genuine' epilepsy and epileptiform seizures. His great lecture, 'A study of convulsions', published in 1870, contains the essence of nearly all our modern ideas concerning the nature of epilepsy. While Jackson spent the next 30 years of his life in further interpretation of the phenomena of epilepsy, as he did this he began to back away from many of the more radical implications of his earlier brilliant insights. He seems to have done this to make his views more palatable to his contemporaries, but this also encouraged him to interpret varieties of epilepsy in relation to a conceptual scheme of 2, and later 3, hierarchal levels of nervous system functioning. The result is that today's reader of Jackson's later papers can be left rather bewildered and it is only by reading the whole corpus of his work that his enormous conceptual contribution to present-day epileptology can be appreciated.

摘要

到1870年,在开始分析癫痫的临床现象并将其与尸检数据相关联的5到6年时间里,35岁的约翰·休林斯·杰克逊对癫痫本质形成了一种与同时代人截然不同的观点。他认识到癫痫发作起源于大脑皮层,而非当时人们所认为的延髓,并且他发现所谓的“真性”癫痫和癫痫样发作之间没有根本区别。他于1870年发表的伟大演讲《惊厥研究》包含了几乎所有我们现代关于癫痫本质的观点。虽然杰克逊在接下来的30年里致力于进一步阐释癫痫现象,但在此过程中,他开始背离其早期卓越见解中许多更为激进的观点。他这样做似乎是为了让自己的观点更容易被同时代人接受,但这也促使他根据神经系统功能的二级(后来是三级)层次概念框架来解释各种癫痫类型。结果是,如今阅读杰克逊后期论文的读者可能会感到相当困惑,只有通读他的全部作品,才能领会他对当今癫痫学所做出的巨大概念贡献。

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