History of neuropsychology through epilepsy eyes

Abstract

In the 19th century, Hughlings Jackson relied on clinical history, seizure semiology, and the neurologic examination as methods for seizure localization to inform the first epilepsy surgeries. In the 20th century, psychological and neuropsychological tests were first employed as both diagnostic and prognostic measures. The contemporary practice of epilepsy evaluation and management includes neuropsychology as a critical component of epilepsy care and research, and epilepsy and neuropsychology have enjoyed a very special and synergistic relationship. This paper reviews how epilepsy has shaped the practice of neuropsychology as a clinical service by asking critical questions that only neuropsychologists were in a position to answer, and how clinical care of epilepsy patients has been significantly improved based on neuropsychology's unique contributions.

Fig. 1.

Sir Victor Horsley (1857–1916). Horsley was 29 years old when he performed his first epilepsy surgery on patient B. James, who was 22 years old.

Fig. 2.

John Hughlings Jackson (1835–1911).

Fig. 3.

The 1905 graph indicating an overall higher level of functining on the Binet–Simon test for patients with epilepsy compared with institutionalized patients with developmental disabilities (Smith, 1905).

Fig. 4.

The Horsley–Clarke frame. Although designed for animals, it was used for depth human electrode placement in 1947 at the University of Illinois (Jensen et al., 1995).

Fig. 5.

First reported effects illustrating sensitivity of hard-word paired-associate learning to dominant hemisphere resection. Although there is a mild post-operative decline seen in the easy-word pairs following dominant hemisphere resection, the decline in hard-word pairs is of much greater magnitude. No post-operative decline is noted in the two patients underling right temporal resection (Meyer & Yates, 1955).

Fig. 6.

Operating theatre at the Montreal Neurological Institute ca. 1958. Assisting Wilder Penfield with the procedure is Herber Jasper (monitoring EEG up upper left portion of picture) and Brenda Milner (back to camera and interacting with patient).

Fig. 7.

Juhn Wada (1924–).