Epilepsy: The delayed sequelae to early head traumas!

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Since age 14, when my younger brother in the early morning hours had his first fit of seizure, that shook us by surprise and terror, our family life changed for ever! Every day and every minute we were in anticipation of him having a fit, at the breakfast table in the morning, that happened the most, or during the day in school while we were not present to protect and taking him to medical attention. It took years until the seizure slowed down and came under control after many trials of anti-epileptics. At the time, nobody, even the medical experts knew the cause of a very common and ancient malady of humans. But while I was not yet even in medical school, I knew that during his childhood, he had several falls with head traumas, though I could not put things together and make a sense of the trauma as a common cause of epilepsy, that then was called “idiopathic”, meaning unknown cause!

Epilepsy or seizure that has been recorded as one of the oldest disease of the humans, as far back as 2000 BC in Akkadian records in Mesopotamia, has been affected commons and greats such as Julius Caesar and Alexander the Great. The disease for centuries had been known through ignorance as caused by “possession by evil spirits”, or named the “sacred disease”. First it was Hippocrates, the father of medicine who in the fifth century BC, rejected the idea that the disease was caused by spirits, and proposed that epilepsy was not divine or satanic in origin, but a medically treatable disease of the brain. He also proposed, heredity an important cause, and described worse outcomes if the disease presents at an early age, and instead of referring to it as the sacred disease, he called it the “great disease” giving rise to the modern term “grand mal” used for tonic–clonic seizures. Despite this landmark ancient work of the father of medicine, evil spirits continued to be blamed until at least the 17th century, and inflicted people with epilepsy were stigmatized, shunned, or even imprisoned, or put in asylums side by side with the mentally ills, or the criminally insanes. This was resolved and epilepsy was accepted as a disease of the brain only when in the mid-1800s, the first effective anti-epileptic medication, “bromide” relatively treated some cases. (1)

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