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Richard Bright and epilepsy
  1. J M S Pearce
  1. Dr J M S Pearce, Department of Neurology, Hull Royal Infirmary and Hull York Medical School, Anlaby Road, Hull HU3 2JZ, UK; jmspearce{at}freenet.co.uk

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Before the work of Todd, Hughlings Jackson, and Herpin, Richard Bright in the 1830s was largely responsible for the notion of a cortical basis for epilepsy, which opposed the established view that epilepsy originated in the medulla. Bright described several partial and complex partial seizure patterns. He also located epileptogenic lesions in the grey (cineritious) matter whence they might be transferred to produce disordered and involuntary motions.

When Richard Bright1 began clinical practice, the prevailing idea was that epilepsy was essentially a rapidly reversible disorder of consciousness, the genesis of which lay in the medulla. After the primitive notions of divine, diabolical and mystical causes had waned, epilepsy was considered an idiopathic disease without discernible cause. The concept of cortical epileptogenesis was largely initiated by Bright (1789–1858), in 1831, and was later developed by Robert Bentley Todd (1809–1860) in his 1849 account of post-epileptic hemiplegia.2 3 It was rediscovered, quite independently, by Samuel Wilks (1824–1911) in 1866. …

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