As late as in the second half of the 20th century, in Tanzania and other parts of Africa epilepsy was associated with possession by evil spirits, witchcraft, or poisoning and was believed by many to be contagious. In the Salpêtrière, the birthplace of modern neurology, Jean-Martin Charcot found people with epilepsy side by side with the mentally ill, those with chronic syphilis, and the criminally insane. In ancient Rome, epilepsy was known as the morbus comitialis (disease of the assembly hall) and was seen as a curse from the gods. In northern Italy, epilepsy was once traditionally known as Saint Valentines malady. In at least the 1840s in the United States of America, epilepsy was known as the falling sickness or the falling fits, and was considered a form of medical insanity. Around the same time period, epilepsy was known in France as the haut-mal (high evil), mal-de terre (earthen sickness), mal de Saint Jean (Saint Johns sickness), mal des enfans (child sickness), and mal-caduc (obsolete sickness). Patients of epilepsy in France were also known as tombeurs, or people who fall, due to the seizures and loss of consciousness in an epileptic episode.In the mid-19th century, the first effective anti-seizure medication, bromide, was introduced. The first modern treatment, phenobarbital, was developed in 1912, with phenytoin coming into use in 1938. Society and culture
Stigma
Stigma is commonly experienced, around the world, by those with epilepsy. It can affect people economically, socially and culturally. In India and China, epilepsy may be used as justification to deny marriage.
If a person has a previous diagnosis of epilepsy with previous imaging, repeating the imaging is usually not needed even if there are subsequent seizures.For adults, the testing of electrolyte, blood glucose and calcium levels is important to rule out problems with these as causes. An electrocardiogram can rule out problems with the rhythm of the heart. A lumbar puncture may be useful to diagnose a central nervous system infection but is not routinely needed. In children additional tests may be required such as urine biochemistry and blood testing looking for metabolic disorders. Together with EEG and neuroimaging, genetic testing is becoming one of the most important diagnostic technique for epilepsy, as a diagnosis might be achieved in a relevant proportion of cases with severe epilepsies, both in children and adults. For those with negative genetic testing, in some it might be important to repeat or re-analyze previous genetic studies after 2–3 years.A high blood prolactin level within the first 20 minutes following a seizure may be useful to help confirm an epileptic seizure as opposed to psychogenic non-epileptic seizure. Serum prolactin level is less useful for detecting focal seizures. If it is normal an epileptic seizure is still possible and a serum prolactin does not separate epileptic seizures from syncope. It is not recommended as a routine part of the diagnosis of epilepsy. Differential diagnosis
Diagnosis of epilepsy can be difficult.