Representations of epilepsy on the stage: From the Greeks to the 20th century

The description of epileptic seizures in the classical opera

Epilepsy or epileptic seizures have only rarely been described in the classical opera. Four operas were detected, in which epileptic seizures are described also by musical means. Three of them ("Der Golem" by Eugen d'Albert; "Idiot" by Mieczyslaw Weinberg; "Otello" by Giuseppe Verdi) describe a generalized tonic-clonic epileptic seizure by a descending chromatic scale. One opera ("The turn of the screw" by Benjamin Britten) describes temporal lobe seizures by overtone music played by the instrument celesta.

Knowledge of and familiarity with epilepsy in U.S. adults: Results from the 2017 ConsumerStyles Online Panel Survey

Examining and improving knowledge and attitudes about epilepsy has been a public health priority because of stigma around the disorder. This study had three goals: (1) to update estimates describing U.S. adults' perceived knowledge about epilepsy, seizure first aid, and confidence in providing seizure first aid; (2) to examine U.S. adults' recognition of common signs and symptoms of generalized and focal seizures to inform public awareness efforts; and (3) to provide baseline estimates of exposure to an Epilepsy Foundation public awareness campaign, #ShareMySeizure, launched in November, 2016. Four sets of epilepsy questions were included on the 2017 Porter Novelli ConsumerStyles survey, an online panel survey of the U.S. adult population. We examined differences in study outcomes by sociodemographic factors and familiarity with someone with epilepsy. Small percentages of U.S. adults felt knowledgeable about epilepsy (16%), knew seizure first aid (25%), or reported having confidence in being able to help someone having a seizure with appropriate seizure first aid (20%). Fewer adults were familiar with signs of focal seizures compared to generalized seizures. About 1% of U.S. adults had heard of the #ShareMySeizure campaign. Television and family and friends emerged as the most common sources of information for those who reported hearing something about epilepsy. About 33% of U.S. adults wanted to learn more about epilepsy. Knowledge about epilepsy among the U.S. public is suboptimal, though generally on par with that of more common conditions such as heart disease, eye conditions, and ovarian cancer. U.S. adults need and want more information about epilepsy, appropriate seizure first aid training, and recognition of seizure symptoms.

Heracles and epilepsy: the sacred disease

Epilepsy is one of the most dreaded and terrifying human afflictions. One of the many names it has received was Sacred Disease, during Greek times. Heracles served as a source of the divine connotation that epilepsy received in ancient times, as he was one of the most important demigods in Greek mythology. However, several authors have attributed Heracles' actions to a seizure, including Hippocrates, who described the sacred disease on his "Corpus Hippocraticum." This paper reviewed some of the publications on the myth and content of the text of Hippocrates, in relation to the current knowledge of the disease.

Neuroscience and Greek mythology

This article highlights the major reflections of ancient Greek mythology in modern neuroscience. An analysis of ancient Greek texts and medical literature using the MeSH term mythology was performed to identify mythological references pertaining to neuroscience. The findings are discussed in relation to etymology, early conceptualization of the nervous system structure and function, incipient characterization of neuropsychiatric disease, and philosophical stance to the practice of medicine in ancient Greece. The search identified numerous observations in clinical neurology (e.g., stroke, epilepsy, cognitive and movement disorders, sleep, pain and neuromuscular medicine, neuroinfectious diseases, headache, neuroophthalmology, and neurourology), neurosurgery, and psychiatry, as well as basic neurosciences (e.g., anatomy, embryology, genetics, pathology, and pharmacology) concealed in ancient myths. Beyond mere etymological allure and imaginative reflections in science, these fables envisage philosophical concepts that still tantalize our protean medical practice today.

Pharmacies for pain and trauma in ancient Greece

PURPOSE

To summarize pharmacies for pain and trauma in ancient Greece, to present several pharmaceutical/therapeutical methods reported in myths and ancient texts, and to theorize on the medical explanation upon which these pharmacies were used.

METHOD

A thorough literature search was undertaken in PubMed and Google Scholar as well as in physical books in libraries to summarize the pharmacies and pain practices used for trauma in ancient Greece.

RESULTS

Archeological findings and historical texts have revealed that humans have always suffered from diseases and trauma that were initially managed and healed by priests and magicians. In early Greek antiquity, the term pharmacy was related to herbal inquiries, with the occupants called charmers and pharmacists. Additionally, apart from therapeutic methods, ancient Greeks acknowledged the importance of pain therapy and had invented certain remedies for both acute and chronic pain management. With observations and obtaining experience, they used plants, herbs, metals and soil as a therapeutic method, regardless of the cultural level of the population. They achieved sedation and central and peripheral analgesia with opium and cold, as well as relaxation of smooth muscle fibers and limiting secretions with atropina.

CONCLUSION

History showed a lot of experience obtained from empirical testing of pain treatment in ancient people. Experience and reasoning constructed an explanatory account of diseases, therapies and health and have provided for the epistemology of medicine.

Does surgery help in reducing stigma associated with drug refractory epilepsy in children?

INTRODUCTION

Epilepsy has several comorbidities and associated stigma. Stigma associated with epilepsy is well known and prevalent worldwide. Surgical treatment is an established treatment for drug refractory epilepsy. Following surgery in children, it is possible that the stigma may reduce, but such an effect has not been studied earlier.

MATERIALS AND METHODS

Analysis of prospectively collected data was performed for pediatric patients at a single tertiary center for treating epilepsy. Child stigma scale, as described by Austin et al., was used to evaluate stigma both pre- and postoperatively. Analysis was done using Paired t test.

RESULTS

In this study, following surgery, there was significant reduction of stigma (P<0.001). This was proportional to the reduction in seizures, though there were 9 (30%) patients, who due to persistent neurodisability did not have any reduction of stigma despite having good seizure outcome.

CONCLUSION

Surgery in drug-resistant epilepsy helps in reducing stigma. Seizure reduction is probably not the only factor responsible for a change in stigma outcome.

Correlation between volumetric oxygenation responses and electrophysiology identifies deep thalamocortical activity during epileptic seizures

Visualization of whole brain activity during epileptic seizures is essential for both fundamental research into the disease mechanisms and the development of efficient treatment strategies. It has been previously discussed that pathological synchronization originating from cortical areas may reinforce backpropagating signaling from the thalamic neurons, leading to massive seizures through enhancement of high frequency neural activity in the thalamocortical loop. However, the study of deep brain neural activity is challenging with the existing functional neuroimaging methods due to lack of adequate spatiotemporal resolution or otherwise insufficient penetration into subcortical areas. To investigate the role of thalamocortical activity during epileptic seizures, we developed a new functional neuroimaging framework based on spatiotemporal correlation of volumetric optoacoustic hemodynamic responses with the concurrent electroencephalogram recordings and anatomical brain landmarks. The method is shown to be capable of accurate three-dimensional mapping of the onset, spread, and termination of the epileptiform events in a 4-aminopyridine acute model of focal epilepsy. Our study is the first to demonstrate entirely noninvasive real-time visualization of synchronized epileptic foci in the whole mouse brain, including the neocortex and subcortical structures, thus opening new vistas in systematic studies toward the understanding of brain signaling and the origins of neurological disorders.