The understanding of epilepsy across three millennia

• Published in: Clinical and experimental neurology Vol. 31; p. 1
• Main Author: Eadie, M J
• Format: Journal Article
• Language: English
• Published: Australia 1994
• Subjects: Epilepsy - etiology; Epilepsy - physiopathology; Humans; Neurology - trends
• ISSN: 0196-6383

The phenomena of epilepsy have been known for at least 3000 years, the earliest recorded account being in an Akkadian text called the Sakikku (written around 1067-1046 BC). Over nearly all the subsequent centuries the popular belief has been that epilepsy is a disorder of supernatural origin, and to some extent such ideas have carried over into medical thought. In Western civilisation, the long dominant belief was that epilepsy was due to possession by a devil or a demon, an interpretation given authoritative support by the miracle story of the cure of the epileptic child which is recorded in all three synoptic Gospels. However, there have been many other interpretations e.g. epilepsy as a consequence of wrong doing or of lunar or magical influences. Such ideas began to die out only in the past 200 years. From Hippocrates (c. 400 BC) onwards, there has been a continuing line of thought that considered epilepsy a medical condition due to natural causes. The hypotheses concerning its pathogenesis have ranged from excess phlegm in the brain, through boiling up of the vital spirits in the brain (Paracelsus), explosion of the animal spirits in the centre of the brain (Willis), heightened reflex activity at a spinal (Marshall Hall) or medullary level (Brown Séquard), to Hughlings Jackson's notion of an occasional, an excessive, and a disorderly discharge' in part of the cerebral cortex. Among thinking men, epileptology in the past century has proved largely to be a matter of exploring the ramifications of Jackson's concepts.