Historical Sources on Epilepsy Surgery: From Antiquity Through the End 20th Century

Abstract

The history of epilepsy is an associate of humanity, and the reports date back to antiquity. Almost all ancient cultures, including the Babylonians, Egyptians, Greeks, Indians in pre-Buddhist period, Iranians, Chinese, and Byzantine epoch, bear witness to epilepsy. Therefore, the earliest beginnings of surgical treatment and epilepsy surgery can be traced back to antiquity. Trepanation as an attempt to treat the disease has often been found in prehistorical tombs (Neolithicum). In antiquity, fasting, a healthy diet, regulation of excretions, medical gymnastics and a decent lifestyle were used as treatment for epilepsy as a non-surgical solution. In the Middle Ages, the basis for treatment fell into three main categories: Conventional (diet and botanical remedies), magical (phases of the moon, trephining of the skull) and religious beliefs (fasting, prayer, exorcisms, and social marginalization). The first neurosurgical operations on epileptic patients with focal semiology were performed during the early 19th century, and began with Godlee, Sommer, Macewen and later Horsley. From that time on, discoveries on epilepsy surgery progressed at a faster pace that started in a historical journey from ancient times until the end of the 20th century.