John Hughlings-Jackson's writings on the auditory aura and localization of the auditory cortex

Abstract

Purpose: To relate John Hughlings-Jackson's findings of the auditory aura to his ideas about the "dreamy state," and localization of primary auditory cortex. Methods: We reviewed Hughlings-Jackson's writings on the auditory aura and his integration of the auditory aura into his description of the "dreamy state." To integrate Hughlings-Jackson's postulations about the auditory aura and David Ferrier's localization of primary auditory cortex, we also reviewed Ferrier's localization of auditory cortex in animals. Results: Hughlings-Jackson described three cases of the auditory aura, which he integrated with his concept of the "dreamy state" (now known as mesial temporal epilepsy). In doing so, he described the current concept of elementary and complex auditory auras. Hughlings-Jackson also associated the auditory aura with seizures that began in the "auditory centre of Ferrier." Whereas Ferrier showed respect and admiration for Hughlings-Jackson's work as a whole, he did not integrate Hughlings-Jackson's ideas of localization of the auditory epileptic aura with his work in localizing the primary auditory cortex in animals. Conclusions: Hughlings-Jackson outlined the modern concept of elementary and complex auditory auras and correctly correlated it with primary auditory cortex. The history of Hughlings-Jackson's auditory aura reflects the history of his ideas of epilepsy as a whole, which closely parallel our modern concepts of focal epilepsy.