Treating Epilepsy 1857 – Epileptic Seizures

Epilepsy is a neurological disorder characterised by seizures that cause sudden changes in the brain's electrical activity. These changes may cause unusual movements, behaviours, emotions and sensations. In ancient cultures, epilepsy was sometimes associated with being cursed by spirits, attacked by demons, witchcraft or being in contact with God.

Some forms of epilepsy have been linked to genetic mutations, while others may result from an imbalance in nerve signalling chemicals. Some forms can be triggered by external stimuli such as sudden changes in light. 

Today, medical scanning tools such as EEG, MRI, CAT and PET are used to assess and diagnose epilepsy. Epilepsy can usually be controlled with medication or surgery, such as removal of a lesion causing abnormal electrical activity in the brain. In severe forms, removing the cortex of a brain hemisphere may be the only option for reducing seizure frequency and severity. Alternatively, electrical devices are used to stimulate the vagus nerve in the neck or deep structures in the brain.

• In 1857, British physician Charles Locock observed that potassium bromide, a simple salt (KBr), had anticonvulsant (antiepileptic) properties. Locock believed that KBr reduced sexual desire and that this directly accounted for its success in treating seizures (a mistaken belief). 
• In 1868, Scottish psychiatrist Thomas Clouston conducted clinical trials to determine the correct dosage, and the trials showed that patients had fewer seizures while taking KBr.
• By the mid-1870s, London's National Hospital was consuming more than two and a half tonnes of KBr each year. KBr may be considered the first effective drug for epilepsy. 
• In 1912, phenobarbital (a barbiturate or central nervous system depressant) was introduced on the market; no more effective drug had been found before then. 

KBr is still used to treat epilepsy in dogs and cats and is also used in humans in some countries. Today, more than 20 drugs with different benefits and adverse effects are used to treat epilepsy.

Description of the article image: A depiction of Saint Valentine in a ceiling fresco (1740). In the image, a child with infantile spasms syndrome (a condition arising from brain damage in children with epilepsy) is shown with demons fleeing from the child.

Historical figures mentioned in the article: Charles Locock (1799–1875), Sir Thomas Smith Clouston (1840– 1915)

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