Origins and development of surgical treatment of epilepsy

ABSTRACT

Purpose: to provide a concise history of the surgical treatment of epilepsy. we reviewed clinically the medical literature, periodicals and books, related to the subject. it is reported that during the Neolithic period holes were placed in the skull of seizure sufferers to let out evil spirit. Dudley, in 1828, performed the first document craniotomy for the relief of epilepsy. Jackson, in 1873, was the first to recognise that epilepsy was due to an abnormal discharge of the gray matter, thus paving the way to its modern surgical treatment. Forester and Penfield laid down the scientific foundation for the surgical management of seizures in 1930. The latter consolidated the surgical technique, which was made possible thanks to the development of electroencephalography introduced by Berger in 1929. Temporal lobectomy became standardised and other cortical excisions perfected. Excision of smaller foci became possible with the advent of computed tomography and magnetic resonance imaging. Video electroencephalography, positron emission tomography, single photon emission computed tomography and other technical advances improved the methods of localisation and the results of surgery. Other advances in the surgical management of epilepsy include corpus callosotomy in 1940, hemispherectomy in 1950, hemispherectomy in 1950, multiple subpial transactions and cerebellar stimulation in 1973. it is thanks to the global and concerted effort of groups of specialists, including pathologist, physiologists, physicist, neurologists, and neurosurgeons that the predicament of patients with uncontrolled seizures can be, at present, improved through surgery