Epilepsy and brain function: common ideas of Hughlings-Jackson and Wilder Penfield

Abstract

From studies of epilepsy, Hughlings-Jackson proposed a model of brain function including levels of consciousness, a hierarchy of nervous centers, and a sensory-motor relationship. Hughlings-Jackson's ideas influenced Wilder Penfield, a pioneer of electrical stimulation for mapping of the human cerebral cortex. From his work with electrocortical stimulation in patients with epilepsy, Penfield observed what he referred to as a "record of the stream of consciousness," similar to Hughlings-Jackson's "subject consciousness." Penfield expanded upon Hughlings-Jackson's work and suggested that although higher and lower centers explained reflex movements, another separate unaccounted for force controlled voluntary movements. These two functional units he termed the "computer (or automatic sensory-motor mechanism)" and the "mind's mechanism (or highest brain mechanism)." The ideas of John Hughlings-Jackson and Wilder Penfield represent a continuum of thought about the relationship of epilepsy and brain function and continue to be relevant to our current understanding of memory function and the mind-brain relationship.