Epilepsy through history

Did you know?

Epilepsy is not a single phenomenon, but a class of brain disorders with the same mechanism of origin.

The word epilepsy is derived from the Greek word "epiléptikos" – "one who is grabbed by something", "who is held by something" ,or similar. Epilepsy as a disease is a later word appearing in late Latin as "epilepsia". It is an ancient disease that can be traced in all civilizations of which any medical records exist.

As epileptic seizures usually manifest in a dramatic way that is shocking to witness, there have been many presumptions and speculations about the origin of the disease. People used to believe that epileptic seizures resulted from possession by an external, supernatural force, with an evil character and bad influence, and that it therefore had to be be expelled or exorcised.

Epilepsy in the era of Babylon

The earliest accurate report of epilepsy is held at the British Museum in London. It represents part of a Babylonian medical text written over 3000 years ago. The Babylonians were good observers of clinical phenomena. They recorded exceptional descriptions of many types of seizures that we can still recognize today. They also understood certain aspects of the prognosis, including the possibility of death due to epilepsy, as well as the condition of the body after the attack. However, the concept of pathology was not known to them. Therefore, seizures were recognized in terms of possession, that is, that the body has been possessed by various evil spirits.

Ancient Greeks and epilepsy

Hippocrates, in 500 BC, was the first to assume that the seat of the disease was in the brain.  Hippocrates’ words: “It appears to me that the Sacred Disease (name for epilepsy) is in no way more divine or sacred than any other disease. On the contrary, it has specific characteristics and originates from specific causes. The seat of the malady is in the brain.” Hippocrates also explained that epilepsy can be chronic and that it is possible to treat. The Hippocratic concept had little influence on the rooted belief in supernatural causes of the disease. 1

The path to modern neurology

The “supernatural” character of epilepsy has thus been maintained for a very long time, and its traces can be detected even today, in particular in the form of prejudices and social influences accompanying the disease. It was not until the 17th and 18th centuries that the Hippocratic concept of epilepsy, as a disorder of brain function was established in Europe. During this period, epilepsy became one of the topics of discussion about the identification and determination of nervous and mental diseases and differences between them. Definition of the differentiation criteria led, among other things, to the beginning of modern neurology in the 19th century. 2

Epilepsy today

Today, we know epilepsy very well. Epilepsy is not a single phenomenon, but a class of brain disorders with the same mechanism of origin. The behaviour of chemical carriers in the nervous system of the patient indicates that there is a misregulation of excitation and inhibition effects. Recurrent epileptic seizures result from altered brain cell function. There are many different causes of epilepsy. It can occur as a result of head injury, inflammation, impairment of brain development, heredity, poisoning, metabolic disease, in rare cases (in children) a tumour; in some patients the cause remains unknown. Today, good knowledge of the disease allows us to control epileptic seizures in 70% of cases.

1 Temkin, Owsei. The Falling Sickness. The John Hopkins University Press. Baltimore. 1971.

2 The text is in part summarized from: WHO. Atlas,Epilepsy care in the World. 2005.