1934.] PSYCHIATRY. 443

Epilepsy. XIII : Aura in Epilepsy. (Arch. of Neur. and Psychiat., vol. xxx,
p.@ Aug. , 1933.) Lennox, 11―.G., and Cobb, S.

The authors analysed the reports on 1,359 non-institutional epileptics. Aur@e
were present in 562%, which agrees with Gowers' 57% on 2,013 cases. They
were less frequent in patients having only petit nial or its equivalent than in

others. A history of aura was not less common in the mentally deteriorated. In
those who had had attacks for five years or longer the incidence of a history of
aura was 27% greater than in those who had had less than five years of seizures.
The mentally deteriorated more frequently had visceral aura@ ; the mentally
normal, aurie of pain, pariesthesia@ or numbness. Aura@ of potential localizing
value occurred in 70% of the patients with a history of injury of the brain

antedating the seizures, and in 41% of those without such a history.
G. W. H. T. FLEMING.

A mbulatory A utomatism in Epilepsy [L ‘¿�automatisme ambulatoise épileptique].
(Ann. Med. Psych., vol. xiv (ii), p. 609, Dec., 1933.) Marchand, C.

Of a series of 1,052 epileptics observed at the out-patients' department of the

Henri-Rousselle Hospital, 69 (64°@) had a history of ambulatory automatism.
This paper includes full reports and details on 43 cases (@@‘attacks). In 36 cases
the automatism occurred in persons previously subject to classical epilepsy ; in
5 cases convulsions only appeared at a later date, while in 2 cases there were typical

epileptic automatism without fits.
@Etiology differed in no way from that of other epileptics (infantile convulsions,

8 ; cranial trauma, 6 ; neuro-syphilis, i ; hereditary syphilis, 2). It is noted that

practically all subjects were adults at the time of the first fugue. The onset is
sudden, rarely preceded by an aura (2 cases), and very seldom directly by a convul
sion. Duration is variable—a few minutes to 24 hours. Return to consciousness

is usually sudden ; there is marked fatigue, the subject often sleeping for several

hours. In practically all the attacks there is complete amnesia for the incidents
of the automatism ; in a very few cases vague memory traces are observed. During
the automatism, in 37 cases the subject walked only ; in the others he bicycled,
trained, “¿�trammed ‘¿�‘¿�or motored. Characteristic of the epileptic fugue is the

absence of motive or end. The individual is clearly in a somnambulistic state ; the

higher faculties have ceased to function and walking is rarely normal.
The writer recognizes three degrees. In the first, medullary and motor centres

concerning walking alone persist. In the second, associated habitual reflexes

permitting the avoidance of obstacles and dangers are also uninhibited. In the

third degree the individual accomplishes in a mechanical fashion complicated
acts sufficiently correctly for his condition not to be commented upon.

A section is devoted to the differential diagnosis, which is considered to be
straightforward in the majority of cases. There is a further section on medico
legal problems. In the writer's experience, contrary to popular belief, the epileptic
in a fugue state is nearly always calm, showing no evidence of agitation, violence

or brutality. Of the patients observed, one attempted to strangle his wife, one

violated a grave, another stole, one left a restaurant without paying his bill and
three urinated in public. S. ‘¿�vI.COLEMAN.

Presbvophrenia [Uber Presbyophreniei. (Arch. f. Psychiat., vol. xcix, p.@ 1933.)
Bostroem, A.

The author thinks that presbyophrenia, although a definite clinical entity,
cannot be distinguished anatomically from other senile psychoses. He defines it

as a senile disorder in which there are no particular defects except disturbance
of memory and impressionability (Merkfahigkeit). He purports to discover

why. in some cases, the senile changes in the brain give rise to a clinical picture
of presbyophrenia. Twelve cases are described (i i females and i male) . All
patients not only showed a slightly hypomanic temperament, but were also very
active personalities, who had previously succeeded in coping with the stresses

LXXX. 30