HEALTH

 

By NICOLAS LABRANCHE
Technique Informatique

 

When
Epilepsy
Racks
Our

Brain

The human brain has fascinated the whole of humankind through the ages by its wondrous prowesses as well as its arcane complexity. Given that it is such a complex organ, it’s no surprise that brain disorders are just as arduous to understand. For instance, people used to explain some particularly controversial brain phenomena such as epilepsy seizures by asserting that these were the result of being possessed by the devil. However, a brilliant Canadian neurosurgeon called Wilder Penfield couldn’t handle the several flaws in our comprehension of brain disorders and more specifically, he wasn’t satisfied with most of the treatments for epilepsy that were proposed in his time. The upcoming paragraphs will briefly set forth the definition of epilepsy, the causes of this disorder and lastly, the surgical procedure pioneered by doctor Wilder Penfield, which is also known as the Montreal Procedure.

Wilder Penfield (1891 – 1976) was a Professor of Neurology and Neurosurgery at McGill who became incredibly prominent in the numerous areas in which he had been involved. Ever since he was a young child, Wilder was determined to succeed throughout his studies and thus he generally managed to remain top of his class. Not only did he show an astonishing performance academically, but he was also a truly skilled athlete, and played football in order to receive a prestigious scholarship. Early in his surgeon career, Penfield was already being quite ambitious hence what he declared back in 1921: «Brain surgery is a terrible profession. If I did not feel like it will become different in my lifetime, I should hate it. » During his career, the neurosurgeon did make various contributions towards neurology and especially in the field of epilepsy. Many friends of him asserted that he was a great human being with a profound desire to improve the life of his patients.

To begin with, it is essential to properly define what epilepsy genuinely is for the sake of clarity. Epilepsy is a merely neurological disorder whereby the affected individual is at risk for recurrent unprovoked seizures. Quite evidently, there is no static definition for this disease and therefore, there is actually a myriad of ways to describe it. Nonetheless, it is always crucial not to neglect the definition of an epileptic seizure. In rather simple terms, epileptic seizures are the events that are directly caused by an exceedingly high level of neuronal activity in the brain, which necessarily causes symptoms that may be either innocuous thought disturbances or severe physical convulsions. Among the most recurrent symptoms that can be observed in the course of a seizure, there are temporary confusions uncontrollable jerking movements of the arms and legs, loss of consciousness or awareness and diverse psychic symptoms. Two main types of seizures exist; focal seizures and generalized seizures. Depending on the type of the seizure, symptoms may vary as well as the treatments; Convulsions that are due to epilepsy can be extremely harmful as they may eventually result in injuries or even in permanent sequelae. Indeed, the victims often hurt themselves against surrounding objects while they’re convulsing. Furthermore, it might injure the brain itself and thus considerably harm their cognitive skills for their entire lifetime.

Following on the definition of epilepsy and epileptic seizures, let us approach the scientific causes of this brain disease more deeply. The causes vary depending on many factors such as the age. When it comes to newborn children, epilepsy is usually due to brain malformations lack of oxygen during birth, low level of blood sugar, blood calcium, blood magnesium or other electrolyte disturbances, inborn errors within the metabolism, intracranial hemorrhages and maternal drug uses. As far as older children are concerned, causes are often congenital conditions, head traumas, genetic factors and infections. It is also possible to develop epilepsy later on as a senior after a stroke, a trauma or even because of other neurological disorders including Alzheimer’s disease.

Considering the huge variety of causes, it somehow complicates the task of finding out the real cause for each individual. Accordingly, the cause remains unknown for roughly half of everyone with epilepsy. Thus far, scientific explanations were not brought up yet. Let us go ahead with the neurologic root of the disorder according to a doctor from Medicinet.com: “Epilepsy is a brain disorder in which clusters of nerve cells, or neurons, in the brain sometimes signal abnormally. Neurons normally generate electrochemical impulses that act on other neurons, glands, and muscles to produce human thoughts, feelings, and actions. In epilepsy, the normal pattern of neuronal activity becomes disturbed, causing strange sensations, emotions, and behavior, or sometimes convulsions, muscle spasm, and loss of consciousness. During a seizure, neurons may fire as many as 500 times a second, much faster than normal. In some people, this happens only occasionally; for others, it may happen up to hundreds of times a day.” That being said, you can tell right off the bat that epilepsy is an excessively laborious topic.

Even though we are currently very inclined to treat most of the epilepsy cases, it was not thus a few decades ago. Doctor Wilder Penfield came up with an entirely new surgical procedure to treat epilepsy. He named it the Montreal Procedure as he pioneered it at the Montreal Neurological Institute of McGill University. Along with Dr. Herbert Jasper, Penfield developed this new neurological approach to annihilate epileptic seizures. The procedure began with the administration of a local anesthetic by the surgeon. The aim was to keep the patient conscious during the whole process so that he is able to describe how he feels in the meantime the surgeon was probing the tissue of his brain. Consequently, this enabled Penfield to identify the exact location of seizure activity and then make it cease completely. With this particular method, more than half of his patients recovered.

In the end, Wilder Penfield is a Canadian who has undoubtedly improved medicine and revolutionized our understanding of the human brain. He managed to inspire many people thanks to his great humanity and his mastermind. Epilepsy would perhaps still be a very complicated disease to treat if Wilder had not lived so we must be thankful for what he did and bequeathed to our generation. Despite the humongous contribution of Penfield, a lot of questions remain concerning the human brain. Penfield went even further and kept asking himself throughout his life whether or not there was any sign of the existence of the human soul in the brain and tried to find an answer all the way to his death. Will we ever find the answer?

 

            

 

Home  |  Paper Editions  |  Team