There is no way to know for certain how long epilepsy and seizures have been prevalent due to the fact that there are accounts of seizures in the earliest records we have throughout history. Epilepsy has a long and storied history, throughout which it has often been misunderstood and misdiagnosed. It’s only now looking back at historical accounts that we can see how far we’ve come in our understanding of epilepsy, and also how far we still have to go.
As previously mentioned, accounts of what we now suspect to be seizures go back as far as the first medical records we know to exist. In fact, the oldest known record of a seizure is written in Akkadian, a language that was commonly spoken in ancient Mesopotamia. This text is estimated to have been written in around 2000 BC. The Code of Hammurabi, also of Mesopotamia also lists what sounds suspiciously like a seizure as a reason that a slave can be returned for a full refund.
It’s only now, looking back through a lens of modern medicine and knowledge that we can identify these accounts as epilepsy (or potentially epilepsy). Back in ancient times, seizures were often thought of as more spiritual afflictions. The Ancient Greeks, for example, believed epilepsy to be a form of spiritual possession which was widely associated with genius and divine spirit, hence why it was commonly known as the ‘sacred disease’. However, in ancient Mesopotamia, it was thought of as an affliction requiring an exorcism.
In Ancient Rome, it’s widely known that people would refuse to eat or drink from the same pottery as someone who had epilepsy for fear that they might catch it themselves. A common diagnosis for epilepsy during these times was to light a type of coal known as ket or gagates and ask the person to inhale the fumes, which would often induce a seizure.
Greek Philosopher Hippocrates, widely known as the Father of Medicine, was sceptical of all referrals of epilepsy as a spiritual affliction and was the first recorded person to hypothesise that it came from within the brain itself. He is quoted as saying: “I am about to discuss the disease called ‘sacred’. It is not, in my opinion, any more divine or more sacred than any other diseases, but has a natural cause … the fact is that the cause of this affection … is the brain …”. Although we know today that he was correct, his teachings and thoughts at the time were widely ignored or misunderstood. This event could be considered the discovery of epilepsy.
During the middle ages there were very few notable advancements in the field of epilepsy. In Europe, until the late 17th century it continued to be widely associated with demonic possession leading to widespread stigma and an unpleasant world for those with epilepsy.
Although at the outset, there was very little change, there was work going on behind the scenes to uncover more about epilepsy, particularly in Persia. Physicians and scholars of Hippocrates began studying epilepsy in more detail and building on the work and writings of the Greek Philosopher who came before them.
These Persian physicians were the first to notice that some people were born with epilepsy, whilst others developed it commonly from head injuries. They also found that it could be controlled by diet. A learning that we still continue to utilise as a treatment today in the form of the ketogenic diet.
The 19th and 20th centuries may be a world away from ancient Greece, Mesopotamia or Rome, but that doesn’t mean that the world had started to fully understand epilepsy or rid itself of the stigma that it had been associated with for many years prior. In fact, as late as the mid 20th Century, epilepsy was thought to be a spiritual possession in places including Tanzania and various areas within Africa.
Bromide, the first known effective anti-seizure medication was developed in the mid 19th century by Sir Charles Locock as one of two treatments he claimed to have used successfully to treat ‘hysterical epilepsy’ in women. Whilst Bromide was effective, his other treatment was to extract over crowded teeth.
Bromide is no longer used as an epilepsy medication, largely due to the development of more effective treatments. The first of these was phenobarbital, which was discovered in 1912 which led to phenytoin being used as early as 1938.
In more recent history, there have been great advancements in the field of epilepsy and a much more inclusive world for those with epilepsy. There are multiple organisations that are dedicated to the advancement of epilepsy medical technology and destigmatising and educating people about epilepsy.
That being said, just because there have been improvements and a better understanding throughout the world, it does not mean that stigma and discrimination does not remain. There is still a long way to go and many things that need to be understood in more detail before we can say that we truly understand epilepsy and are able to treat it with more accuracy.