The Conditioned Inhibition of Uncinate Fits

IT has been repeatedly observed, since ancient times, that a specific sensory stimulus could arrest epileptic fits, but the physiological explanation of this phenomenon is still unknown. Similarly, seizures spontaneously arrested during the aura (aborted for reasons which cannot be ascertained, but not apparently by sensory stimulation) are reported by almost every epileptic from time to time. In one of the rare references to this phenomenon in the last twenty years. S. A. K. Wilson (1935) noted that the grand mal fit sometimes "fails to evolve according to rule... the process becomes arrested at some point, for reasons difficult to fathom. " He called these abortive fits "fragments." It has also been observed that spontaneous arrests during different stages of the aura are more frequently noted after treatment with anti-con vulsant drugs, especially phenytoin. (The suggestion so often made when a spontaneous arrest or "fragmentary " fit occurs—that the "thresh-old for the spread of the fit was not achieved at that moment " is mere tautology.) This phenomenon of seizure-arrest, known for so long, has not been seriously investigated in the laboratory or clinic although hundreds of papers have recently been published on methods of precipitating fits. This neglect is surprising since a study of naturally arrested seizures is both of theoretical interest and pertinent to therapy. In the last and most exhaustive study of the phenomenon of sensory arrest of seizures, Gowers (1881) pointed out that the repeated arrest of Jacksonian fits by ligatures could permanently alter the subsequent development of the fit. He reported the case of a "patient whose fits always commence in the hand by a sensation which passes up the arm, and could be arrested by the ligature applied just above the elbow. After employing the ligature in this manner for some months, he found that the fits, commencing in the same way, stopped of their own accord at the spot 1The opinions expressed in this article are those of the author and are not necessarily to be construed as representing those of the Navy Department or the Naval service at large.