One - 1860–1914: The Birth of Modern Epilepsy

Summary

The modern era of epilepsy can be said to date from around 1860. In the ensuing decades epilepsy was at the centre of an enormous range of endeavours which included Hughlings Jackson’s landmark works, the theory of cerebral localisation, the introduction of bromide and then phenobarbitone therapy and the first attempts at the surgical resection of the epileptic focus. It was the period when idiopathic epilepsy (‘genuine epilepsy’) was considered to be an inherited degenerative brain disorder, associated with mental symptoms and deficiency and a specific ‘epileptic personality’. It was the period when neurology first became a recognisable medical specialty, special hospitals for epilepsy opened and epilepsy colonies were formed all over the world. Lombroso considered epilepsy and criminality to have close connections. Inpatient treatment was conducted within the asylum system by psychiatrists. Epilepsy was associated with enormous stigma and was widely hidden or denied. In 1911, eugenics was proposed as a solution to the problems caused by epilepsy. Dostoyevsky, Zola, Dickens, Hardy and others included epilepsy in their books, and leading authors suffered from epilepsy but concealed their condition. International medical and psychiatric congresses were held, and during one of these, the International League Against Epilepsy was formed.