The Cerebrospinal Fluid in `Essential' Epilepsy.

TIIE data in the literature dealing with the cerebrospinal fluid of patients with epilepsy are unsatisfactory. Most of the reports present the incomplete findings of a few cases. Also, many authors have ml-ade nio attempt to separate the cases in which the convulsions are associated with inflammatory, expanding or other lesions of the brain from the cases in which there is no apparent cause for the seizures. Neel 1 examined the fluids of 381 cases with convulsiv:e seizures. In 129 of these cases the cause of the conivulsive seizures was unknown. In this group he found that 11 per cent. had more than six cells and 14 per cent. had an increased protein cointent. This is in marked contrast to the percentage of abnormalities in the group of cases with convulsive seizures of known cause. In this group 69 per cent. had an increase in the cell count of the fluids and 75 per cent. an increased protein content. Patterson and Levi,2 in their 50 cases, measured pressure with patients in the unorthodox sitting position and their measurements of pressure cannot be used. Twenty-two per cent. of the fluids had five or more cells per c.mm. ; 10 per cent. had a positive globulin test; the sugar and chloride concentration was normal in the 10 exanmined cases. Marchand and Courtois,3 in 100 cases of ' essential epilepsy,' measured the pressure (horizontal position) in 17 patients, in three of whom it was above 250 mm. of water. In 19 per cent. the protein was more thani 30 mg. The highest cell count was 6 per c.mm. Kulkow,4 in 50 cases, found an increased pressure in half of the cases. The cell count was increased in four cases and the globulin in 22. The sugar content was determine(d in 15 cases and found to be normal. Fay 5 reported the range of cerebrospinal fluid pressure readings