In a hundred unselected cases of epilepsy there were--
No apparent exciting cause in 43 per cent. Possible exciting cause in 57 per cent.
Of the cases where a possible exciting cause was present, the following is an analysis:--
Blow or injury to head in 28.1 per cent. Uterine disorder in 22.8 per cent. Domestic trouble in 15.7 per cent. Disease of the nervous system in 8.7 per cent. Fright in 5.2 per cent. Depression in 5.2 per cent. Pregnancy in 5.2 per cent. Mental strain in 3.5 per cent. Sunstroke in 3.5 per cent. Emotion in 1.7 per cent.
Thus, in no fewer than 16 per cent. of the total number of cases, and 28.1 of those in which a possible exciting cause was present, did epileptic seizures follow injuries to the head. Of the cases recorded under uterine disorders, it must be stated that these conditions were as much the accompaniments as the cause of epilepsy, the relations between the two being as follows:--
Attacks occurring at menstrual periods in 61.5 per cent. Attacks associated with irregular menstruation in 30.7 per cent. Attacks associated with uterine disease in 7.6 per cent.
An attempt was made in twenty-two cases to ascertain whether, in women, the age at which the epileptic attacks began had any relation to the period at which the catamenia commenced, with the following results:--
Average age at which attacks began 14.6 years Average age at which catamenia began 14.6 years
This shows singularly enough exactly the same figures, and serves to point out, that in women, the earliest manifestation of puberty is a decided exciting cause for epileptic attacks. It must however be stated that, in the female epileptics, the attacks commenced before the age of puberty in 16.9 per cent. of their numbers. Of the 8.7 per cent. of cases included under the term "diseases of the nervous system," the epilepsy was associated with hemiplegia in all.
In a hundred unselected cases of epilepsy there were--
Epilepsia gravior in 62 per cent. Epilepsia mitior in 10 per cent. Epilepsia gravior and mitior in 28 per cent.
_Premonitory Symptoms._--In the cases in which epilepsia gravior was present there were--
No premonitory symptoms in 34.4 per cent. Premonitory symptoms in 65.5 per cent.