E. Braun / R. Cassirer / R. Hirschfeld
connoted by the term. A major attack ranges from a disturbance on the highest Ievel (the conscious aura) to disorders of sensory, motor, and visceral nature; other forms may be confined almost entirely to affection of one of these systems. Once initi. ated, the epileptic process spreads far and wide through the neuraxis, or remains strictly confined; the aura, occurring by itself, may constitute a larval fit; loss of consciousness, as in various examples of petit mal, can supervene a. lmost monosymptomatically. A faint, a cry, a laugh, may be as definitely epileptic as a flicker of finger and thumb, cyanosis, or defaecation. The possibili ties in truth are Iegion; no rigid semeiological framework can be fashioned to embrace them all. Some clinical types may appear remote from epilepsy as currently understood and the objection be raised that they would thus be made equivalent to other orders of phenomena never thought epileptic. Clinical traits such as rapidity of onset, paroxysmal character, failure of control, crudity, disorderliness, transience, interruption of the stream of consciousness, and recurrence are probably foremost in the mind whenever we think of 'attacks' or 'fits' of any sort, but none is pathognomonic, while from a given case one or several may be lacking and others seemingly foreign to usual conceptions be in evidence.
