Epilepsie. Mus&eacut;e Allemand de l'Epilepsie á Kork. Therapy

Therapy in the Ancient World

Attempts to treat epileptic seizures and the disease epilepsy date back to prehistoric times. In every historical epoch, the beliefs which people held about the disease dictated the types of therapy which were used.

In the time before Hippocrates, when the "sacred disease" was thought to be an illness sent by the gods, people would offer sacrifices, seek expiation and take part in religious acts under the instruction of doctor-priest(preferably in the temple) in an attempt to be cured.

The supporters of Hippocratic medicine, who believed that epilepsy had a natural cause, tried to treat the disease using natural means (humoral pathology: the ancient physiological theory of fluids or humors). The treatment was based on dietetics, or a structured, "sensible" lifestyle. This dietetic therapy was based on three pillars: dietary regulations, the regulation of excretions, and physiotherapy.

In addition to dietetics, medicines, which were mainly of a herbal nature, played only a secondary role.

Therapy in the Middle Ages (1/2)

In the Middle Ages, epilepsy was no longer considered to have natural causes but was rather thought to be the work of devils, evil spirits and demons ("morbus daemonicus"). As a result, "therapeutic" methods also changed and took the form of prayer, fasting, offering sacrifices, making pilgrimages or undergoing "exorcisms"

People turned to several saints for direct help or prayed to them to intercede with God on their behalf.

Many sacred, devotional objects were used to combat epilepsy (treatment using the saints and sacred objects: "hagiotherapy").

After the plague, epilepsy was the disease with the most saints who were "responsible" for providing a cure, and the most important one in Germany was Valentin (probably because of the similarity of his name with the German words for "to fall" [fallen], "falling sickness" [Fallsucht], and "don't fall down" [fall net hin] ).

Alongside the medieval Christian attempts to find a cure, various superstitious methods of treatment also developed, e.g. spells, witchcraft, fetishism, the use of amulets. These actually continue to be used in some countries today.

›› St. Valentin

Therapy in the Middle Ages (2/2)

›› Fraisenkette

So-called "Fraisen utensils" played an important role, especially in south Germany. "Fraisen" was the name given to epileptic seizures in small children, e.g. febrile seizures (fraisan is an old gothic word meaning: to bring danger).
People used the following items in an attempt to ward off seizures: Fraisenkette (a chain or necklace), Faisenpulver (a powder), Fraisenstein (a stone), Fraisenmünze (a coin), Fraisenuhr (a clock).

›› Peony

"Phytotherapy - treatment using plants and parts of plants - was also widely used in the Middle Ages. During this period there was hardly a plant which was not used to treat the "falling sickness", as epilepsy was called. The most important plants were: valerian, peony, mugwort, thorn-apple, common henbane, mistletoe, belladonna, foxglove, bitter orange and Peruvian bark .

Therapy from the Renaissance to today (1/2)

During the Renaissance, chemical substances were increasingly used to treat the "falling sickness". The most important of these were: copper (which had already been used by the Ancient Greeks), zinc oxide, silver nitrate, mercury, bismuth and tin.

Today, there is no doubt that none of these plant or chemical substances had any effect whatsoever on epileptic seizures.

It was not until the second half of the 19th century, when people began to learn more about epilepsy and medicine that drugs were finally found which did have an effect on epileptic seizures. The first two substances which were proven to have an anti-epileptic effect and which are still used today, were bromine (first used in 1857) and phenobarbitone (first used in 1912).

›› Castoreum

›› Human skulll

›› Mugwort

Therapy from the Renaissance to today (2/2)

modern anti-epileptic drugs Today, there are about 20 chemical substances which can be used successfully to treat epileptic seizures, either singly or in combination therapy.

Just under 60% of all people with epilepsy can become seizure free under modern drug therapy. In another 20% the seizures can be drastically reduced, and only in one fifth of all epileptic patients do modern anti-epileptic drugs fail to have any effect whatsoever.

Modern epilepsy surgery can help a number of these "therapy-resistant" patients, however.