Michael Ondaatje’s Warlight (2018), his latest novel to-date, contains nostalgic elements of strangeness and cartography. In this paper, I short-circuit such themes with health under medical humanities, which heeds a Nietzschean counsel of close reading in literature. To do so, I explore the case of Rachel's illness, namely her epileptic seizures, as an instance that drives her impetus for active forgetting and eventual convalescence. A close hermeneutical reading of the novel can reveal that both of Nietzsche’s ideas on active forgetting (...) and convalescence provide traction in terms of what this paper constructs as Rachel’s pathography or narration of illness. Shifting the focus from the main narrator, Nathaniel, I argue that it is not the novel's reliance on memory but the subplot events of Nathaniel's sister and her epilepsy that form a substantial case of medical or health humanities. (shrink)

Purpose: Some enigmatic remarks and behaviors of Socrates have been a subject of debate among scholars. We investigated the possibility of underlying epilepsy in Socrates by analyzing pathographic evidence in ancient literature from the viewpoint of the current understanding of seizure semiology. Methods: We performed a case study from a literature survey. Results: In 399 BCE, Socrates was tried and executed in Athens on the charge of “impiety.” His charges included the “introduction of new deities” and “not believing in (...) the gods of the state,” because he publicly claimed that he was periodically and personally receiving a “divine sign,” or daimonion, that directed him in various actions. We found textual evidence that his daimonion was probably a simple partial seizure (SPS) of temporal lobe origin. It was a brief voice that usually prohibited Socrates from initiating certain actions. It started when he was a child, and it visited Socrates unpredictably. Moreover, we found at least two descriptions of Socrates’ unique behavior that are consistent with complex partial seizures (CPSs). The fact that Socrates had been experiencing both SPSs and CPSs periodically since childhood makes the diagnosis of temporal lobe epilepsy (TLE) likely. Conclusions: We hypothesize that Socrates had a mild case of TLE without secondary generalization. This is the first report in 2,400 years to present a pathographic diagnosis of TLE in Socrates based on specific diagnostic features in the ancient textual evidence. Our study demonstrates that the knowledge of modern epileptology could help understand certain behaviors of historic figures. (shrink)

As Peter Niebyl has documented, one of the issues in which the Wittenberg-based physician and philosopher Daniel Sennert (1572–1637) departed from Paracelsus and his followers was the concept of disease. Paracelsus and some of his followers regarded diseases as real beings—so-called “disease-entities” (entia morbis) that can enter into the body of a living being and thereafter possess a clearly defined location in the affected organism. 1 For Sennert, such a view is a dangerous confusion between disease and its causes. According (...) to him, causes of disease can be present in an organism without actually causing a disease (Sennert 1629, p. 253). Moreover, he shares the traditional Christian doctrine .. (shrink)

In their work Gilio et al. investigate the mechanisms involved in the regulation of excitability of the cortex in epileptic subjects, and in particular their epileptogenic threshold.

This paper defends the idea that alterations in social perception of people with epilepsy may be crucial in the development of co-morbidities, involving a circular and mutual relationship between the person and her/his social environment, between the self and the world. We aim at exploring the role of these processes in psychopathological phenomena in people with epilepsy. Through a phenomenological and enactive account of intersubjectivity and the model of circular causality, enriched with interviews conducted with people with (...) class='Hi'>epilepsy, we develop the hypothesis that the originary domain of a person’s experience with epilepsy expands and modifies the fundamental interrogation of the sense of self. Furthermore, we observe how disturbances in the dynamical coupling and coordination among agents may contribute to psychopathological phenomena, and to changes in intersubjectivity and social perception. (shrink)

Epileptogenesis involves an increase in excitatory synaptic strength in the brain in a manner similar to synaptic potentiation. In the present study we investigated the mechanisms of short-term synaptic potentiation in patients with focal epilepsy by using 5 Hz repetitive transcranial magnetic stimulation (rTMS), a non invasive neurophysiological technique able to investigate the mechanisms of synaptic plasticity in humans. Ten patients with focal idiopathic cortical epilepsy were studied. 5 Hz-rTMS (10 stimuli-trains, 120% of motor threshold, RMT) was delivered (...) over the first dorsal interosseus (FDI) motor area of both (affected and unaffected) hemispheres. Changes in the motor evoked potential (MEP) size in the FDI muscle during the trains and the RMT were measured and compared between the hemispheres. 5 Hz-rTMS was also delivered in a group of healthy subjects over both hemispheres. 5 Hz-rTMS in patients elicited a reduced MEP facilitation compared to normal subjects. The reduced MEP amplitude was more evident in the affected hemisphere than in the unaffected hemisphere. RMT in the affected hemisphere was higher than in the unaffected hemisphere and in healthy subjects. Our findings showing a decreased response to 5 Hz-rTMS over the affected hemisphere, differently from the expected results suggest a reduced cortical excitability in epileptic patients. We hypothesize an altered balance between excitatory and inhibitory circuits in epileptic patients under chronic therapy. (shrink)

Objective: The purpose of this study was to compare the depression and resilience scores of children and adolescents with epilepsy and healthy controls. Furthermore, its purpose was to investigate whether resilience mediates the relationship between epilepsy and depression. -/- Methods: 100 children and adolescents (46 patients and 54 healthy controls) were included in the study. Questionnaire on sociodemographic data was administered to the all participants at the time of application to our center and all participants were asked to (...) complete the Anxiety and Depression Scale in Children-Revised (RCADS-CV) and Child and Adolescent Psychological Resilience Scale (CYRM-12). -/- Results: 46 epilepsy patients had higher RCADS-CV depression scores (P=0.008) and lower psychological resilience scores (P= 0.001) compared to the control group. Although there was a negative correlation between psychological resilience scores and RCADS-CV depression scores in epilepsy patients and the control group, this correlation was not statistically significant. -/- Conclusion: We found that children and adolescents with epilepsy had lower psychological resilience and higher depression symptoms compared to healthy controls. (shrink)

Dear editor, we read with interest the article by Gilio et al.. Previous transcranial magnetic stimulation studies in focal epileptic patients brought to controversial results.

Objective: Kindling is an animal model of epilepsy induced by electrical stimulation of the brain. The present study aimed to present a different perspective with a bibliometric approach by using the literature data on the “Kindling model” related keywords in the Web of Science (WoS) online database between 1980 and 2023. -/- Methods: The bibliometric data were obtained from the online database WoS and analyzed and visualized with the VoS Viewer Program. The bibliometric datasets were analyzed and visualized regarding (...) article productivity numbers according to years, article productivity numbers according to countries, the most used keywords according to authors, and cross-country cooperation. -/- Result: Considering the results of the analysis of the published datasets, 2022 was determined as the year with the highest article productivity, and an acceleration was observed in the publication increase rate on the subject in general. When the order of the countries in the top three in the number of article productivity was examined, the USA, Germany, and Japan are the main countries, respectively. The most used keywords by the authors were determined as “Epilepsy”, “Kindling”, and “Hippocampus”. In the cooperation among countries, it was found that the USA, Germany, and Japan had more cooperation with other countries, respectively. -/- Conclusıon: This study will contribute to the literature by providing a detailed understanding of the research basis, relevant research results, current research boundaries and main research focus in the Kindling Model. (shrink)

The aim of this study was to obtain a baseline for clinical application of electroencephalography (EEG) in children and to evaluate the EEG findings in children with various acute and chronic central nervous system disorders and nonepileptic events. EEG records of 250 patients were studied in Neurophysiology Departments of Queen Rania Al-Abdullah Hospital for Children in Jordan. For each patient who had undergone EEG the following data were recorded: age, sex, source of referral (inpatient or outpatient department), reason for EEG, (...) diagnostic impressions, clinical presentation, the result of the EEG examinations and clinical correlation between the seizure type and EEG finding. Males (55%) were slightly outnumbered than females. The majority of cases were between 6-12 years. Total of 63.2% of all referrals for EEG were from outpatient clinics while inpatients accounted for 36.8% of referred cases, with Pediatric Neurology Department referrals being the highest (28.8%). Majority of diagnosis at referral were suspected epilepsy (80%) with epileptiform EEG abnormalities in 32%. Over all 64% the EEG records were normal, including all EEG records of children with syncope and headache. We conclude that there are many unnecessary routine EEG recordings in children. Investigation of epilepsy and acute encephalopathies appear to be the most valuable indications for routine pediatric EEG. EEG can be helpful in classification of seizures. Finding a way to reduce EEG requests is recommended. (shrink)

This essay provides a medical theory that could clarify enigmas surrounding the historical Socrates. It offers textual evidence that Socrates had temporal lobe epilepsy and that its two types of seizure manifested as recurrent voices and peculiar behaviour, both of which were notorious hallmarks of Socrates. Common and immediate criticisms against the methodology of retrospective diagnosis are addressed first. Next, the diagnostic reasoning is presented in detail. The possibility of temporal lobe personality in Socrates is also considered. The important (...) implication of this theory is that one of the charges against Socrates, introducing new divinities, was a now well-known neurologic symptom. (shrink)

Neurological syndromes in which consciousness seems to malfunction, such as temporal lobe epilepsy, visual scotomas, Charles Bonnet syndrome, and synesthesia offer valuable clues about the normal functions of consciousness and ‘qualia’. An investigation into these syndromes reveals, we argue, that qualia are different from other brain states in that they possess three functional characteristics, which we state in the form of ‘three laws of qualia’. First, they are irrevocable: I cannot simply decide to start seeing the sunset as green, (...) or feel pain as if it were an itch; second, qualia do not always produce the same behaviour: given a set of qualia, we can choose from a potentially infinite set of possible behaviours to execute; and third, qualia endure in short-term memory, as opposed to non-conscious brain states involved in the on-line guidance of behaviour in real time. We suggest that qualia have evolved these and other attributes because of their role in facilitating non-automatic, decision-based action. We also suggest that the apparent epistemic barrier to knowing what qualia another person is experiencing can be overcome by using a ‘bridge’ of neurons; and we offer a hypothesis about the relation between qualia and one's sense of self. (shrink)

Although the study of epileptic absence seizures has the potential to contribute a great deal to the scientific understanding of consciousness, this potential has yet to be fully exploited. There have been a number of insightful discussions of consciousness in the context of epileptic seizures, but the basic conceptual issues are still poorly understood and many empirical questions remain unexplored. In this paper I review a number of questions that are of interest to consciousness scientists and identify ways in which (...) the study of absence seizures might bear on their investigation. (shrink)

The first serious scientific studies on the brain date back to the 1800s. Two events led the studies on the brain. The first incident is an accident involving Phineas Gage, a railway worker. The two-meter-long piece of iron that entered Gage's left eye and broke up the anterior frontal lobe of the brain prompted scientists to rethink the brain. Having lived a moral life before the accident, Gage became immoral and evil after the accident. This incident revealed that the brain (...) has a relationship with evil. -/- The second event affecting the brain studies is the split brain syndrome that occurs when the corpuscallosum of patients with epilepsy is cut. The separation of the right and left brains has caused some problems in individuals. For example, while the left brain smokes, the right brain tries to block it, while the left brain drives a car, the right brain wants to get out of the way. The right brain behaves in a childish and impulsive manner and cannot be controlled. -/- After all, any disease, accident or surgery that occurs in the brain can negatively affect people's behavior and make them worse. Then, the neuroscientific origins of the evil issue should be investigated and evaluated according to neuro-philosophy. In this paper, the limits of human freedom, scientific determinism and human responsibility will be set forth. Thus, in the issue of evil, it will be shown that the biological (and psychological) structure of the human being, together with external factors such as the environment, society, education, and culture, and the changes that occur in it, are determined in the human will and choosing evil. (shrink)