Epilepsy-from the Sakikku to hughlings Jackson

The phenomena of epilepsy have been known for over 3000 years. The earliest recorded account is an Akkadian text, the Sakikku, written around 1067-1046 BC. Until comparatively recent times popular belief held epilepsy to be a disorder of supernatural origin, e.g., due to demonic possession. However, there were other interpretations, e.g. a consequence of sinning or of lunar or magical influence. Such ideas began to die out only in the past 200 years. From Hippocrates (c. 400 BC) onwards, there has been a continuing alternative line of thought that epilepsy is an ordinary medical condition with a natural cause. The hypothese concerning its pathogenesis have ranged from excess phlegm in the ventricles of the brain, through boiling up of the 'vital spirits' in the brain (Paracelsus), explosion of '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 (1870) notion of 'an occasional, an excessive, and a disorderly discharge' in part of the cerebral cortext. At the time Jackson's concepts began to be known, an effective treatment of epilepsy (potassium bromide) had recently appeared after centuries of ineffective medical measures. Since the 1860-1870 decade, epileptology has proved largely a matter of exploring the ramifications of Jackson's insights and of developing the therapeutics of the disorder in the awareness that effective treatment of possible.