Descriptions of clinical semiology of seizures in literature.

Literary texts are an important part of the cultural history of many fields of medicine. Accounts of epilepsy are frequent, and descriptions of seizure semiology are often included with varying detail. This review looks at these, and considers the authors' background knowledge of epilepsy. The first group of writers suffered seizures themselves. Some of them provide remarkable and novel insights into the subjective symptoms and experiences in and around seizures.A second group draws from their own observations of seizures in others who may have been close relatives or fortuitous strangers. Here, the outside view prevails, and seizures may be described with clinical objectiveness. Commonly, the reactions of onlookers become part of the narrative beyond the seizure description. The third group writes from second-hand knowledge, which may be other observer reports, interviews with people with epilepsy or with experts, information being available in dictionaries, medical textbooks and the like. The professional standard of most writers means that the resulting descriptions are quite accurate, but there are also examples of poor use of such information. Many authors' sources are not known, but can be assumed to belong to one of the above categories, and we can sometimes guess. It appears that even authors with no first-hand knowledge are often aware of seizure types other than the most widely known, generalised tonic-clonic, and there is a widespread interest in warnings and how the afflicted respond to them. The quality of an author's fictional account of epilepsy should not be judged from a translation, because specific aspects and the language involved in the description may have been misunderstood by the translator.