Case XXXV. Epileptic Fits—Five Years’ Duration—Preceded by Cataleptic Fits, during the Ten previous Years—Operation—Cure.
In the beginning of April, 1862, a single lady, æt. 28, came under my notice, giving the following account of herself.—When about ten years old had a fit, whilst she was sitting at needlework; she fell down suddenly as if dead, and remained insensible for two hours; was very ill for three weeks after the attack. Was quite well until the age of fourteen, when she began to have them every three months. When about twenty-two had an interval of eleven months without a fit, but frequently fainted during that period. During the time she was in the fits she would be perfectly unconscious. She was told that her limbs were quite rigid, and always remained in the exact position in which they were when the fit commenced. In 1857 the fits changed in their nature—the patient at first falling down quietly, but subsequently becoming very convulsed, and trying to hurt herself. The first of this nature lasted two hours and three-quarters. Has lately had them much oftener, but not always of the severe form. Has had eight severe fits in the last two years and a half, besides the milder, which come sometimes a dozen in a fortnight. Is unconscious, but always knows when she has had one. Foams at the mouth, but makes no noise. Has frequently fallen down suddenly in church and other public places. Has been under many physicians, all of whom have been of opinion that she is suffering from genuine epilepsy.
April 2. Clitoris excised.
April 6. Has had no attack, but complains of occasional pain in the top of her head.
She never had an attack after the operation. Returned home in a month, and shortly afterwards she was thrown out of a pony chaise; she had no fit, but wrote that, prior to treatment, a very much slighter accident would have immediately produced one.
I heard of this lady later in the year; she was still quite well. Not having heard since from her, as was agreed when she left me, I am satisfied that she has had no relapse.