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Kasper BS et al. - This article undertakes a careful evaluation of original publications in the epilepsy literature and demonstrates that the concept of MD is anchored within a set of papers written from 1890 to 1930 and their contemporaneous reception in classic neuropsychiatric handbooks. Both the text of these early publications and the development of the MD concept are examined and illustrated. This perspective provides insight into historical scientific views of epilepsy as a mental disease that was thought to be dependent largely on hereditary or developmental factors.

Exclusive Author Commentary
Burkhard S. Kasper, 06/25/09

"Microdysgenesis" (MD) as a term refers to the concept, that certain, exclusively microscopically detectable tissue features do indicate a cerebral malformation. A huge number of cytologigal findings have been incorporated into this category. You have to know, that MD as a term has been deleted from current classifications of cortical dysplasia (see Palmini 2004); however many features are still contained in the new categories of "focal cortical dysplasia type I" or "mild malformation of cortical development-mMCD". MD-FCD I - mMCD, this is still a controversial issue in epileptology, and it was from the beginning! MD as a term and concept seems to start with the works of Meencke in the 1980ies: whenever you read a recent article, his papers are referenced as having introduced the term. However, as shown in this article, the idea and concept of MD are very old and go back to the very beginning of neurohistology; by reading this article you can find interesting links to schools of neuropathology, outstanding personalities/researchers involved and the times, when physicians started to look for the cause in the brains of epilepsy patients. It is one aim of the article to outline and highlight the development of this major topic, because it still forms part of important pathophysiological theories in current epileptology.

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