When was epilepsy first discovered

In , Sir Locock — discovered the anticonvulsant and sedative effect of potassium bromide, and he starts to treat his patients with this substance. Since that time, potassium bromide became the first drug of choice in the treatment of epilepsy, until the discovery of phenobarbital by a German physician, Hauptmann — , in The drug company Bayer, under the brand name Luminal, introduced phenobarbital to the market.

Hauptmann used phenobarbital as a sedative for his epileptic patient, and he discovered that their epileptic attacks were susceptible to the drug. The absence of the sedative effect of phenytoin, the next drug used as antiepileptic, leads to the delay of its use as anticonvulsant until despite its synthesis by Heinrich Biltz — in It was introduced as an anticonvulsant by Merritt — and Putnam — in under the name Dilantin.

Phenytoin substitutes potassium bromide and phenobarbital as the first-line drug of choice for the prevention of partial and tonic seizures and for the treatment for acute cases of epilepsies and status epilepticus [ 38 , 39 , 40 , 41 , 42 ]. A new antiepileptic drug was introduced in under the name of trimethadione. Richards and Everett report the use of trimethadione to prevent pentylenetetrazol- induced seizures and for the treatment of absence seizures.

In the s, a set of new antiepileptic drugs were introduced: carbamazepine in , primidone in , ethosuximide in , and sodium valproate in [ 43 ]. Serum level of antiepileptic drugs was first introduced in by Buchtal and Svenmark [ 44 ].

Other antiepileptic drugs were introduced in the s, including clobazam, clonazepam, and piracetam. The last decade of the twentieth century and the early years of the twenty-first century mark the beginning of the use of new antiepileptic drugs.

Among these drugs are vigabatrin , lamotrigine , gabapentin , felbamate , topiramate , tiagabine , zonisamide in Japan and in the USA , levetiracetam , pregabalin , rufinamide , lacosamide , eslicarbazepine , and perampanel The field of anticonvulsant drugs is dynamic and in the last two decades a new generation of antiepileptic drugs introduced to the market, and there are a number of very new antiepileptic drugs which are under various stages of drug development such as brivaracetam and retigabine.

The aim of the researches in this field is to improve tolerance and effectiveness of the drugs and to improve the quality of the life of the patient through improvement in the pharmacokinetics, safety, and efficacy of these drugs. The role of diet in the management of epilepsy dated back to the era of Hippocratic were fasting and other types of diet used for the treatment of epilepsy [ 13 ].

The use of ketogenic diet diet full with fat and low in protein and carbohydrates for the treatment of epilepsy started in by two French physicians, Guelpa and Marie, who reported a decrease in the number of seizures in 20 children and adults with epilepsy when treated with ketogenic diet [ 45 ]. In , an American physician, Hugh Conklin, stresses the importance of the ketogenic diet in the management of epilepsy since he believed that epilepsy caused by toxins damages the brain cell.

He had a personal interest in ketogenic diet and tried to treat his nephew, who suffered from drug-resistant epilepsy, by this method. By using ketogenic diet, he had encouraging results. Since that time, many authors published many papers, but none explained the anticonvulsive mechanisms of ketogenic diets [ 46 , 47 ].

In , the first neurosurgical operation for an epileptic patient with brain abscess was done by Heyman [ 30 ]. Posttraumatic epilepsy was the most common indication for the operations done at that time. At the beginning of the twentieth century, a great advance in neurosurgical operations for epileptic patients is done, started by Dandy — who introduced hemispherectomy in and continued by Gibbs and Lennox in who introduced the notion of operating the epileptogenic focus [ 31 , 48 ].

A further advance in the surgical procedure for epileptic patients was done by Penfield, Jasper, and Theodor Brown Rasmussen — They introduce the Foerster method for removing epileptogenic lesions in epileptic patients, invented Montreal procedure using local anesthesia to remove part of the skull and expose brain , and published one the greatest classics in neurology, Epilepsy and the Functional Anatomy of the Human Brain , in [ 49 , 50 ].

On the other hand, Van Wagenen and Herren — introduce the procedure of callosotomy, and Bailey — attempts temporal lobectomies for psychomotor seizures [ 51 , 52 ].

The early introduction of EEG and the use of electrocorticography for intraoperative localization and later on the advent of modern diagnostic techniques such as MRI, PET, and SPECT was an important advance in the development of surgical techniques and approaches. Recently the application of microsurgery and the use of multiple transaction and gamma knife had revolutionized the neurosurgical operations for epileptic patients. Throughout the history of epilepsy, many misconceptions and wrong beliefs about the disease are conveyed.

Some of these are referred to earlier in this chapter. These misconceptions and beliefs are variable in different parts of the world, from society to society and era to era, and it may lead to rejection, denial of education, and isolation in both developed and developing countries.

In the antiquity, one of the popular beliefs was that epilepsy is a contagious disease. People used to spit at a person with seizure and refuse to use the same dish. These beliefs continued in the Middle Ages where the clergy and synods of the early Christian church separated the possessed from the faithful because they thought that the possessed would desecrate the holy objects and would infect the sharing dishes and cups [ 53 ].

An update was issued in , which was basically unchanged from the previous classifications, except the list of epileptic syndromes was revised. The next major revision was issued in A primary motivation was to have the classification of seizures and epilepsies reflect all of the advances made in basic and clinical neurosciences, so that this could be incorporated into clinical practices.

These categories were not mutually exclusive. The group concluded that no one specific organization was proposed for the revised classification, but rather, the various forms of epilepsy were to be organized according to those aspects that were most pertinent to a specific purpose. This included the continuous lack of complete scientific understanding in epileptogenesis to support such a classification scheme, presumed failure to incorporate known advances in the field, and criticism of the new terminology that some thought to be unnecessary.

Others found that it was too difficult to incorporate into daily clinical practice. For this most current classification, the ILAE introduced a new methodology approach; they used the Internet to solicit public comments and criticism and appointed a separate expert panel to review these remarks, rather than ratification by the General Assembly through a vote by the representatives of the ILAE Chapters from around the world. While no classification scheme will be perfect at this point, the current proposed scheme was fairly well received.

It took a necessary step toward aligning clinical practice with scientific advances in the field of epileptology. The task force continues to believe that the new classification scheme is a significant step forward in the large majority of patients with epilepsy. This review aims to objectively summarize the chronological development of the concepts of seizures and epilepsy, from the earliest notion of the disease to the most current views.

While it is not feasible to discuss every historical figure or detail every classification proposal, we hope the reader has been transported through this evolutionary journey to understand the major milestones in the field.

It is evident that those living as far back as BC were aware of seizures and provided descriptions in line with how we would describe them today.

Through the years, these descriptions have been revised, updated, and recycled, and new terminology has been assigned, in a manner that some would say is just a matter of semantics. However, what is remarkable and clearly manifest is how far we have come in understanding the pathophysiology and etiology of the disease, from magical beliefs, to the idea of the origination in the brain and excess humors, to our current perceptions today.

Classification will continue to be a dynamic process, reflecting new knowledge gained through research and scientific advances. It will undoubtedly engender debate, until our understanding is advanced enough to create a classification scheme based predominantly on scientific grounds. It is hoped that it is relevant to clinical practice and serves as a common language. Importantly, these classification schemes should lead to improved diagnosis and understanding of etiology, and ultimately guide targeted treatments.

He receives from Elsevier an annual compensation for his work as Associate Editor in Neurobiology of Disease and royalties from 2 books he coedited. Dr Patel has no conflicts of interest. We confirm that we have read the Journal's position on issues involved in ethical publication and affirm that this report is consistent with those guidelines. Epilepsia Open. National Center for Biotechnology Information , U.

Journal List Epilepsia Open v. Published online Jan Puja Patel 1 and Solomon L. Solomon L. Author information Article notes Copyright and License information Disclaimer. Puja Patel, Email: gro. Corresponding author. Email: gro. Epilepsia Open published by Wiley Periodicals Inc. This article has been cited by other articles in PMC. Abstract This review aims to highlight the historical hallmarks in the development of the concepts of seizures and epilepsy.

Key Point. Open in a separate window. Historical documents on epilepsy: from antiquity through the 20th century. Brain Dev. Temkin O. The falling sickness , 2nd edn Baltimore: Johns Hopkins, Instruction manual for the ILAE operational classification of seizure types. Glossary of descriptive terminology for ictal semiology: report of the ILAE task force on classification and terminology. Texts and documents. Translation and analysis of a cuneiform text forming part of a Babylonian treatise on epilepsy.

Med Hist. On epilepsy, ch. The extant work of Aretaeus the Cappadocian. London: Sydenham Society, V, On,. Millett D. A history of seizures and epilepsies: from the falling disease to dysrhythmias of the brain. Handb Clin Neurol. A dialogue with historical concepts of epilepsy from the Babylonians to Hughlings Jackson: persistent beliefs.

Epilepsy Behav. Gross RA. A brief history of epilepsy and its therapy in the Western Hemisphere. Epilepsy Res. Peritoneum as an origin of epilepsy from the viewpoint of Avicenna. Neurol Sci. Bird J. West Engl Med J. Cullen W. First lines of the practice of physic. Van Swieten G. The commentaries upon the aphorism of Dr.

Herman Boerhaave. Tissot DM. Paris: Didot le jeune, Des maladies mentales. Eadie MJ. The origin of the concept of partial epilepsy. J Clin Neurosci. Prichard JC. A treatise on diseases of the nervous system, part the first. London: Underwood, West WJ. On a peculiar form of infantile convulsions.

Wolf P. History of epilepsy: nosological concepts and classification. Epileptic Disord. Eadie M. Louis Francois Bravais and Jacksonian epilepsy.

Todd RB. Clinical lectures on paralysis, certain diseases of the brain and other affections of the nervous system , 2nd edn London: University College, Jackson JH. Early pathophysiological theories of epilepsy correctly identified the brain as the site of the problem, but emphasized incorrect causes such as an excess of phlegm in the brain.

Treatments consisted of prescribed diets or living conditions, occasional surgery such as bloodletting or skull trephination and medicinal herbs.

These treatments, often ineffective, had the intellectual advantage of being based on pathophysiological principles, unlike current, more empirical, therapies.

Epilepsy is usually only diagnosed after the person has had more than one seizure. The Greek philosopher Hippocrates BC was the first person to think that epilepsy starts in the brain. Seizures happen when there is a sudden interruption in the way the brain normally works. In between seizures the brain functions normally. Epilepsy is a variable condition that affects different people in different ways.

There are over 40 different types of seizure. What seizures look like can vary. So not all seizures involve shaking. Some people are unconscious during their seizures and so they do not remember what happens to them. It can be really useful to have a description of what happened from someone who saw their seizure to help with diagnosis. Different epilepsies are due to many different underlying causes. The causes can be complex, and sometimes hard to identify.

Sometimes a cause for epilepsy can be found for example a person may start having seizures due to a brain injury or there may be a genetic tendency. Some researchers now believe that the chance of developing epilepsy is probably always genetic to some extent.

Epilepsy statistics. One in 20 people will have a one-off epileptic seizure at some point in their life although this does not necessarily mean that they have epilepsy. One in 50 people will have epilepsy at some time in their life not everyone with epilepsy will have it for life. Around 87 people are diagnosed with epilepsy every day.

Over , people in the UK have epilepsy. There are around 60 million people with epilepsy in the world. Did you know?