Epilepsy and other chronic convulsive disorders : their causes, symptoms, and treatment.

  • William Richard Gowers
Date:
1881
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Licence: Public Domain Mark

Credit: Epilepsy and other chronic convulsive disorders : their causes, symptoms, and treatment. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    means of arresting epileptic fits by Vallender.' I have had no experience of its employment in these attacks, although I have long used it for cutting short hysteroid seizures. TREATMENT DURING AN ATTACK. Little treatment is needed during the attacks of epi- lepsy. In patients who bite the tongue, a cork, or better, a small piece of indiarubber, should be forced between the teeth, and thus the tongue-biting may often be prevented. The patient should be Isid down for obvious reasons. The horizontal posture has been recommended on account of the theory of vascular spasm and cerebral anaemia ; but I am doubtful, from observation, whether the horizontal posture has much influence on either the duration or the severity of the attack. It is necessary to see that the clothes are loose about the neck. If tight, when the neck becomes turgid and swollen, the resistance to the return of blood from the head is increased, and extravasations into the skin or conjunctivae are more probable. Little can be done to arrest the developed attack. Only in the early stage is an attempt to cut it short by any method successful. The hysteroid condition, however, which succeeds a slight fit, may often be cut short by the means presently to be described. The sleep which in many cases succeeds a fit should not be prevented. There is often more headache if the patient is kept awake than if permitted to sleep. The administration of a small quantity of alcohol after an attack does no harm, but it is rarely needed or beneficial. The weakness and pro- stration pass away in a little time without its aid. In the status epilepticus, described on p. ] 93, bromide often fails. Inhalations .of nitrite of amyl have been found useful by Crichton Browne. Chloroform inhalations rarely have a permanent effect. The remedies from which ' Berlin. Klin. Wochenschrift, 1877, p. 185.
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