History of the Early Development of Electroencephalography and Clinical Neurophysiology at the Montreal Neurological Institute: The First 25 Years 1939-1964

Jasper, Herbert H.

doi:10.1017/s0317167100032662

Cited by 12 publications

(12 citation statements)

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“…In this scenario, the close relation and mutual respect of Jasper and Penfield, associated with their interest in epilepsy, created an environment for research and treatment for this disease at the MNI. The history of their accomplishments has been told before (19,20). The case reported offers another example of their valuable pioneer work in the field of epilepsy surgery.…”

Section: Discussionmentioning

confidence: 99%

The First Case of Invasive EEG Monitoring for the Surgical Treatment of Epilepsy: Historical Significance and Context

2005

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Summary:Purpose: Controversy persists about when EEG became a fundamental tool in the preoperative investigation for epilepsy surgery. We revisit Penfield's first use of invasive EEG monitoring, emphasizing its historical importance for the evolution of epilepsy surgery.Methods: Patients' hospital charts and articles published before 1940 regarding EEG and epilepsy or EEG and cerebral lesions were reviewed to evaluate the historical context of the surgery.Results: In April 1939, Penfield performed trephination over both temporal regions and placed electrodes on the dura, intending to lateralize seizure origin in a patient with bitemporal epilepsy. The patient underwent serial EEGs with this technique. The final report of the recordings from epidural leads was "continued random delta activity in the left temporal region indicating a cortical lesion on this side." The pneumoencephalogram showed "the presence of diffuse cerebral atrophy, particularly in the left cerebral hemisphere." Based on these findings, the patient underwent surgery on April 21, revealing a meningocerebral scar in the posterior part of the left temporal lobe. Brain stimulation and electrocorticography delineated the extent of resection, while preserving the speech area. Seizures did not improve.Conclusions: We revisit the first case of epidural EEG monitoring for epilepsy surgery and show that the concept of EEGdirected surgery was already present at the Montreal Neurological Institute in the late 1930s. Key Words: EpilepsyHistory-Neurosurgery-Penfield-Jasper.Engel divides surgery for epilepsy into three historical phases: lesion-directed surgery, EEG-directed surgery, and imaging (lesion)-directed surgery (1). In the first phase, operations were aimed at resection of brain lesions diagnosed by a detailed review of seizure pattern and by neurologic examination. The second phase started when clinicians acknowledged EEG as a tool of prime importance for localization of epileptogenic areas in the brain (2). A monograph by Penfield and Erickson in 1941 contains a chapter by Jasper, in which he remarks, "that a consistently localized random spike or sharp-wave focus worked out on the scalp surface is a faithful guide to a focal cortical epileptic discharge" (3). Nevertheless, the article written by Bailey and Gibbs in 1951 (4) has been considered the milestone between the first and second phases (1). The advent of new methods of imaging brought new perspectives to the understanding of the interaction between lesions and epileptogenic areas in epilepsy.

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Section: Discussionmentioning

confidence: 99%

The First Case of Invasive EEG Monitoring for the Surgical Treatment of Epilepsy: Historical Significance and Context

2005

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“…Penfield's recognition of the importance of neurophysiology in the evaluation of epileptic patients led him to provide in 1939, through support from private citizens and The Rockefeller Foundation, a laboratory for EEG and neurophysiology at the MNI for Jasper (Jasper, 1991). The close integration between neurophysiology and neurosurgery, a mirror of the friendship between Penfield and Jasper, made the MNI the leading center for the surgical treatment of epilepsy during the second half of the 1930s (Fig.…”

Section: Figurementioning

confidence: 99%

From lateral to mesial: The quest for a surgical cure for temporal lobe epilepsy

2007

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SUMMARYPurpose: A gap of more than a hundred years occurred between the first accounts of mesial temporal sclerosis and recognition of its role in the pathogenesis of psychomotor seizures. This paper reviews how the understanding and surgical treatment of temporal lobe epilepsy developed, particularly from the work of Penfield, Jasper, and their associates at the Montreal Neurological Institute (MNI). Methods: Publications on EEG and surgery for temporal lobe seizures from 1935 to 1953 were reviewed and charts of selected patients operated on at the MNI in the same period were examined. Attention was focused on the evolution of surgical techniques for temporal lobe epilepsy. Results: In the late 1930s, some EEG findings suggested deep-lying disturbances originating in the temporal lobe. However, it took another two decades before the correlation of clinical, neurophysiological, and anatomical findings provided evidence for the involvement of the mesial structures in psychomotor or temporal lobe seizures. From 1949 and onward, Penfield and his associates applied this evidence to extend the surgical resections to include the uncus and the hippocampus. Conclusion: The collaborative work of a team led by Penfield and Jasper at the MNI helped to define the role of neurophysiological studies in epilepsy surgery. As a result, the importance of removing the mesial structures in order to obtain better seizure control in patients with temporal lobe epilepsy became firmly established.

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“…Of the next three decades in Montreal, Herbert Jasper wrote, "My time with Wilder Penfield and his family, in which I became an adopted member, working with his splendid enthusiastic staff and hundreds of colleagues and students from all over the world who worked with us, was certainly a most pleasant and productive 27 years of my life." 3 Jasper flourished in Penfield's multidisciplinary institute where the basic scientists worked closely with clinicians. As Penfield was fond of saying, epilepsy became their teacher.…”

Section: Figure 4: Herbert Jasper and Research Fellow David Hubel In mentioning

confidence: 99%

“…(Figure 3) Their publications covered the topics of thalamic-cortical connections, the intralaminar reticular formation and the limbic system, using electronic techniques of unit cell recording, all directed toward unravelling the neural mechanisms of epilepsy. 3 '" (Figure 4) In 1954, a monograph with Wilder Penfield on Epilepsy and the Functional Anatomy of the Human Brain, summarized their experience with hundreds of surgical cases of epilepsy and became the most widely used text in this field. 9 ( Figure 5) A publication on Brain Mechanisms and Consciousness derived from a symposium in 1954, of which Jasper was the principal organizer.…”

Section: Figure 4: Herbert Jasper and Research Fellow David Hubel In mentioning

confidence: 99%

“…He has left for us inimitable accounts that throw light on his early education and how he became more focused on the physiology of the nervous system, with a driving interest in elucidating the mechanism of epilepsy that he pursued in partnership with Wilder Penfield over a quarter-century at the Montreal Neurological Institute. 3 He recounted his later career when he concentrated on the combined method of electrochemical analysis of neuronal activity. 2 Gloor has noted, in a critical analysis of Jasper's rich contributions to neuroscience, that from the very beginning Jasper's aim had always been "to use the EEG as a means to investigate fundamental aspects of brain function, rather than to merely employ it as a diagnostic test".…”

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Herbert Henri Jasper (1906 – 1999): An Appreciation

Feindel

1999

Can. j. neurol. sci.

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Herbert Henri Jasper dedicated his life to studies of the brain in relation to the mind and behavior. He pioneered the application of the electroencephalogram (EEG) for the study of the electrical activity of the brain and used this technique in studies of consciousness, learning and particularly the examination of epileptic discharge. He utilized microelectrode recordings from single brain cells and combined this technique with microchemical analyses to study cortical and sub-cortical activity. He added substantially to our understanding of brainstem and thalamic reticular formations in conditions of consciousness and in relation to petit-mal epilepsy, His work with Wilder Penfield and associates over a quarter century elucidated the mechanisms of epilepsy and added to our understanding of the functional anatomy of the human brain. An enthusiastic and able organizer, Herbert Jasper was responsible for many international conferences on brain science and worked tirelessly to develop international collaboration among investigators of the nervous system, being one of the founders of the International Brain Research Organization and the Society for Neuroscience. His prodigious contributions in basic and clinical research will be recognized by the world community of brain science for years to come.

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History of the Early Development of Electroencephalography and Clinical Neurophysiology at the Montreal Neurological Institute: The First 25 Years 1939-1964

Cited by 12 publications

References 64 publications

The First Case of Invasive EEG Monitoring for the Surgical Treatment of Epilepsy: Historical Significance and Context

The First Case of Invasive EEG Monitoring for the Surgical Treatment of Epilepsy: Historical Significance and Context

From lateral to mesial: The quest for a surgical cure for temporal lobe epilepsy

Herbert Henri Jasper (1906 – 1999): An Appreciation

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