Epilepsy is defined as a chronic non-communicable brain disorder characterized by recurrent, unprovoked seizures. This common neurological condition affects millions of people globally, yet its origins and understanding have been debated for millennia. The “discovery” of epilepsy was not a single event attributed to one person, but rather an evolution in human thought regarding the source of the affliction. The journey to comprehending this condition spans thousands of years, moving from supernatural attribution to physical and, finally, neurological science.
Epilepsy in the Ancient World
The earliest documentation of a condition resembling epilepsy dates back to ancient Mesopotamia, with written records appearing as far back as 4000 BCE. The most detailed early account comes from the Babylonian diagnostic manual Sakkikku, a cuneiform text from roughly 1067–1046 BCE. Tablet 26 of this text described symptoms in detail, including a person whose “neck turning left, hands and feet are tense, and from his mouth froth is flowing without him having any consciousness.”
Despite these accurate clinical descriptions, the prevailing view in ancient societies was overwhelmingly supernatural. Seizures were commonly attributed to divine punishment, demonic possession, or the influence of angry gods. This perception led to the term “The Sacred Disease,” which was used throughout Greece and the Near East. The afflicted were often feared, isolated, or subjected to ritualistic treatments like purifications and incantations.
This pre-medical view dominated human understanding for centuries, framing the condition as a spiritual or moral failing rather than a biological one.
Hippocrates and the First Medical Definition
A revolutionary shift in the understanding of epilepsy occurred with the Greek physician Hippocrates, who lived around 460–370 BCE. The treatise On the Sacred Disease, attributed to the Hippocratic Corpus, firmly rejected the spiritual explanations that had dominated for centuries. The author stated that the disease was no more divine or sacred than any other ailment, proclaiming that it had a natural cause.
This treatise marks the first documented attempt to move epilepsy from the domain of religion to the domain of physical medicine. It polemicized against the “magicians, purifiers, charlatans and quacks” who used superstition to conceal their ignorance. The author argued that if the disease could be cured by incantations and purifications, then those same methods could presumably bring the disease on, disproving the involvement of a deity.
Hippocrates proposed that the condition originated in the brain, identifying it as the source of all mental function. The specific, albeit incorrect, physiological mechanism suggested was a blockage caused by an accumulation of phlegm flowing from the brain into the veins. This imbalance of humors was thought to cool and congeal the blood, causing the seizures.
The true significance of this work lies not in its anatomical accuracy, but in its profound assertion that epilepsy was a physical disorder of the brain, a concept far ahead of its time. The Hippocratic school established the principle that all diseases were subject to rational investigation and had natural origins. This intellectual stance provided the philosophical and observational framework necessary for future medical inquiry.
Establishing the Modern Neurological Cause
The true neurological basis of epilepsy would not begin to be established until the 19th century, with the work of British neurologist John Hughlings Jackson (1835–1911). Jackson is often regarded as the father of modern epileptology, focusing his studies on the clinical observation of seizure progression. He recognized that certain types of focal seizures, which now bear his name as Jacksonian seizures, began in a specific part of the body and “marched” to other areas.
This observation led Jackson to theorize that seizures were caused by a “sudden, excessive, and rapid discharge” of nervous force in the brain’s gray matter. His work laid the foundation for the concept of localization, suggesting that different parts of the body were represented in discrete areas of the nervous system. While his initial theory of the discharge was framed in terms of a chemical or “explosive” force, it was the intellectual precursor to the modern electrical understanding.
Jackson’s theory was later confirmed with the development of the electroencephalogram (EEG) by German psychiatrist Hans Berger. Berger successfully recorded electrical brain signals in humans for the first time in 1924, coining the term Elektrenkephalogramm. This invention provided objective, measurable proof of the electrical nature of brain activity and, crucially, of epileptic discharges.
Berger’s initial recordings described the EEG alterations associated with various conditions, including epilepsy. The EEG demonstrated that seizures were indeed a result of excessive electrical activity in a group of brain cells, thereby validating Jackson’s clinical theory. The ability to visualize and record these abnormal electrical patterns finally solidified the understanding of epilepsy as a disorder of brain electrophysiology.