Cesare Lombroso, cortical dysplasia, and epilepsy: keen findings and odd theories.

BACKGROUND: Cesare Lombroso supported a common origin of criminality, genius, and epilepsy as caused by factors impairing the embryonic development of the CNS, mainly affecting the hierarchically superior neural centers. OBJECTIVE: To describe the first observations of cortical dysplasia in patients with epilepsy by Cesare Lombroso and his coworkers in 1896. RESULTS: To confirm his theories, Lombroso emphasized the need for the direct observation of the patient, using anthropologic, social, neurophysiologic, economic, and pathologic data. With the collaboration of his pupil Luigi Roncoroni, Lombroso described a prevalence of large, giant pyramidal neurons and polymorphous cells through the gray matter of the frontal cortex in 13 patients with epilepsy. Most of the large pyramidal neurons were haphazardly arranged, presenting also an abnormal orientation of their apical dendrites. The number of nervous cells was noticeably reduced, with the presence of abundant gliosis. Moreover, the granular layers were dramatically reduced or absent in most patients, and numerous nervous cells were present in the subcortical white matter. This particular finding was never observed in specimens from criminal and healthy control subjects. Lombroso and Roncoroni explained their finding as evidence of an arrest of CNS development. CONCLUSIONS: More than one century ago, Cesare Lombroso and collaborators described developmental lesions in the frontal cortex of patients with epilepsy, which correspond to what currently is called Taylor's dysplasia. However, they used their observations to support their scientific misconception on the relationship between criminality, epilepsy, and genius.