Bristol Mental Hospital
ABSTRACT
The combination recorded above may perhaps be more frequent than has been reported, though it is unlikely to be very frequent. It seems at least possible that a single pathology may be responsible for both manifestations, and that from some affected extrapyramidal area, a discharge may spread to both hemispheres, producing a generalized seizure. To speculate further would be profitless. It appears certain now that generalized convulsions may ensue from subcortical disease apart altogether from cortical involvement, as shown for example in Cappell and Dott's case; and it is equally certain that obsessional states are associated with ascertained disease of the brain-stem in its upper part. Certain other conditions, such as Gilles de la Tourette's disease, compulsive utterances and tics, and compulsive laughter might be regarded as sharing some of the features of both. It is possible, therefore, that there is a pathological entity which may produce this quite unusual combination of symptoms.