Giancarlo Di Gennaro, Ilaria Ciullo
The Charcot Journal. 2026;2(2):5–11.
Abstract
In the late nineteenth century, Jean‑Martin Charcot played a pivotal role in distinguishing epilepsy from functional seizures at a time when both conditions were often conflated under the concept of hystero-epilepsy. Working at the Salpêtrière Hospital in Paris, Charcot developed a rigorous anatomo-clinical method grounded in systematic observation and detailed documentation, helping transform neurology into an empirically based discipline. Through clinical teaching, photographic documentation, and collaboration with colleagues such as Londe and Regnard, he produced some of the earliest visual and descriptive analyses of seizure semiology and functional neurological disorders. Charcot carefully differentiated seizure types, including petit mal and grand mal, and emphasized the clinical importance of brief absence episodes. His school further advanced the understanding of focal epilepsy, particularly through the work of Albert Pitres, who correlated focal motor seizures with cortical lesions identified at autopsy, anticipating modern concepts of epileptogenic localization. At the same time, Charcot investigated “hysteria”, describing the staged semiology of the “grand hysterical attack” and promoting systematic clinical observation rather than sensational interpretation. Contrary to later portrayals that caracterized him as misogynistic or as having “invented” hysteria, historical analyses suggest that Charcot maintained a rigorous scientific approach and supported the careers of several women physicians. Toward the end of his career, he also proposed that psychological trauma could produce somatic symptoms beyond conscious control, anticipating later developments in dynamic psychology by Janet and Freud. Charcot’s work ultimately clarified the relationship between epilepsy and functional disorders while highlighting the complex interaction between neurological and psychological processes.
Keywords: Jean-Martin Charcot, Epilepsy, Functional Seizures, Hystero-epilepsy, Seizure Semiology, Salpêtrière Hospital