Four - 1970–1995: Epilepsy in a Globalised World

Summary

The basic science of epilepsy made fundamental advances in this period, with the discovery of GABA as the chief inhibitory transmitter and glutamate as the chief excitatory transmitter involved in epilepsy. This spurred intensive research by the pharmaceutical companies and the introduction of a range of new drug treatments, although none were shown to be of superior efficacy to those already existing. Extraordinary progress was made also in the basic science of genetics, although this did not feed into clinical epilepsy. The major investigational advances were CT and then MRI scanning, which transformed clinical practice in epilepsy, and also EEG technologies allowing prolonged monitoring and video-EEG correlation. The number of clinical researchers in epilepsy greatly increased, stimulated by changing university and hospital priorities and the technological advances of the computing era. Advances were made in many clinical fields in epilepsy, including epidemiology, paediatrics, epilepsy syndromes, febrile convulsions and their relationship to temporal lobe epilepsy, SUDEP and status epilepticus. Aided by therapeutic drug monitoring, antiseizure drug monotherapy became commonplace. New drugs and new surgical techniques were introduced. An attempt was made to federate ILAE and IBE under the umbrella of a new organisation, Epilepsy International, but this failed.