You Can Observe a Lot by Watching: Hughlings Jackson's Underappreciated and Prescient Ideas about Brain Control of Movement

John Hughlings Jackson, the 19th-century British neurologist, first described what are today called Jacksonian seizures. He is generally associated with somatotopy, the idea that neighboring brain regions control neighboring body parts, as later represented pictorially in Wilder Penfield's homunculus, or little man in the brain. Jackson's own views, however, were quite different, though this is seldom appreciated. In an 1870 article, Jackson advanced the hypotheses that each region of the cerebrum controls movements of multiple body parts, but to different degrees, and that the march of movements that typically occurs during Jacksonian seizures is caused by the downstream connections of the overactive neurons at the seizure focus, rather than a somatotopic organization of the cerebrum. Jackson's hypotheses, which were based almost entirely on his careful observations of movements during seizures, are well within the range of current hypotheses about how the frontal lobe is organized to control movements and thus deserve renewed attention.