A solitary epileptic episode in an artillery officer (slight concussion of the brain two years before) following extraordinary campaign stress (38 artillery battles in two months).
Case 76. (Bonhoeffer, July, 1915.)
A first lieutenant of artillery, 35, was able to count 38 artillery clashes in which he had taken part in two months of very strenuous, almost daily fighting. Then appeared headaches, anxiety, dizzy feelings, insomnia. Finally one day suddenly, after eating, the lieutenant sustained a loss of consciousness with convulsions, which sent him to his home reserve hospital. The officer had felt nothing before his convulsions came on. The medical report, however, yields no doubt of the epileptic character of the attack.
When he was examined, there was a slight psychopathic depression with a feeling of insufficiency, anxiety, insomnia, restless dreams, over-sensitiveness, and a pessimistic outlook on the future. There were no epileptic traits whatever. There was nothing alcoholic, luetic, or arteriosclerotic about the officer. There was nothing in the childhood or youth of the patient, though there had been a fall two years before, with phenomena of concussion without sequelae. In fact, this fall with concussion had led to no medical examination.
As to the relation of the concussion two years before to the epileptic attack, Bonhoeffer is inclined to interpret the case as one of genuine “reactive” epilepsy on the basis of continuous overstrenuous work for a period of weeks. He regards the previous concussion as soil for this epilepsy.
Re amount of stress occasionally required to bring out epilepsy, compare Hurst’s Cases 64 and 80. It may be recalled that Bonhoeffer is decidedly of the belief that exhaustion has not brought about any actual psychoses, calling attention to the remarkable absence of psychoses among the Serbians after their exhausting campaigns. A general review of war experience indicates, according to Bonhoeffer, the marked power of resistance of the healthy brain.