Institute of History of Medicine and Public Health, Medical School, University of Lausanne, Switzerland.
History of Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece.
Curr Pharm Des. 2017;23(42):6373-6375. doi: 10.2174/1381612823666171024150121.
Epilepsy has been known since antiquity and trepanation has been documented as a therapeutic option. The Greek born physician Aretaeus of Cappadocia (2nd century BC) was the first to recommend trepanation for the treatment of refractory epilepsy to drugs, pointing out the efficacy of the method (Fig. 1). Trepanation was practiced throughout the Middle Ages, as it is proved by the book of "Quattuor Magistri" and during Renaissance as well. In 19th century, Sir Victor Alexander Horsley (1857-1916), combining analysis of clinical presentation with cortical stimulation, performed a series of craniotomies for the treatment of epilepsy Fig. 2. In the following years the advent of electrophysiology and neurosurgery provided a fertile ground for further progress in epilepsy surgery such as the preoperative use of electroencephalography (EEG) to determine the epileptogenic zone by Otfrid Foerster (1873-1941); the research of Wilder Graves Penfield (1891-1976) in Montreal Neurological Institute and the use of stereoelectroencephalography (SEEG) by the neurosurgeon Jean Talairach (1911-2007) and the neurologist Jean Bancaud (1921-1994)) Fig. 3. Nowadays, epilepsy surgery remains a valuable therapeutic option in cases of drug resistant epilepsy.
癫痫由来已久，早在古代就有颅骨切开术作为一种治疗选择的记录。古希腊医师阿雷塔乌斯（Aretaeus of Cappadocia）（公元前 2 世纪）是第一个推荐颅骨切开术治疗对药物难治性癫痫的人，他指出了该方法的疗效（图 1）。颅骨切开术在整个中世纪都有实践，这一点可以从《Quattuor Magistri》一书中得到证明，在文艺复兴时期也有实践。19 世纪，维克多·亚历山大·霍斯利爵士（Sir Victor Alexander Horsley）（1857-1916 年）结合临床表现分析和皮质刺激，进行了一系列用于治疗癫痫的开颅手术（图 2）。在随后的几年里，电生理学和神经外科学的出现为癫痫手术的进一步发展提供了肥沃的土壤，例如，奥弗特里德·福斯特（Otfrid Foerster）（1873-1941 年）使用脑电图（EEG）术前确定致痫区；在蒙特利尔神经学研究所，怀尔德·格雷夫斯·彭菲尔德（Wilder Graves Penfield）（1891-1976 年）的研究以及神经外科医生让·塔莱拉克（Jean Talairach）（1911-2007 年）和神经学家让·班考德（Jean Bancaud）（1921-1994 年）使用立体脑电图（SEEG）。如今，癫痫手术仍然是药物难治性癫痫的一种有价值的治疗选择。
