A few victims are attacked only after excessive alcoholic or sexual
indulgence, some women only during their menses, while other women are free
from attacks during pregnancy, which state, however (contrary to popular
belief), commonly aggravates the trouble. Victims may be free from attacks
during the duration of, and for some time after, an infectious disease;
while Spratling says that a consumptive epileptic may have no fits for
months, or even years.

Some epileptics are normal in appearance, but many show signs of
degeneration. This is common in the insane, but less frequent and
pronounced in neurasthenics. An abnormal shape of the head or curvature of
the skull, a high, arched palate, peculiarly-shaped ears, unusually large
hands and feet, irregular teeth from narrow jaws, a small mouth, unequal
length and size of the limbs, a projecting occiput, and poor physical
development may be noted.

These are most pronounced in intractable cases, in whom mental
peculiarities are most frequently seen--either dullness, stupidity and
ungovernable temper, or very marked talent in one direction with as marked
an incapacity in others. In all epileptics, the pupils of the eye are
larger than normal, and, after contracting to bright light soon enlarge
again.

The facial expression of most epileptics indicates abnormal mentality. When
the seizures have been so frequent and severe as to cause mental decay, the
actions are awkward, and the gait slouching and irregular. Progressive poor
memory is one of the first signs of intellectual damage consequent upon
severe epilepsy.