In this period, the science and medicine of epilepsy continued to expand rapidly, and a selection of the leading theories and practices are described. There were significant scientific advances in relation to mechanisms of epileptogenesis and epilepsy-induced cerebral damage, including work on ion channels, neurotransmitters, cerebral networks and systems. There were major advances in the basic and clinical genetics of epilepsy. Other clinical developments occurred in fields including the epidemiology of epilepsy, status epilepticus, rare causes of epilepsy, the use of big data, and in drug and surgical treatment of epilepsy. Epilepsy research had become a worldwide phenomenon, and the medical literature on epilepsy expanded greatly. In the social sphere, too, epilepsy was changing. The Global Campaign Against Epilepsy raised the profile of the condition at governmental level internationally, and this was a period when political lobbying for epilepsy increased and when the voice of people with epilepsy could be strongly heard on social media and also, for the first time, in numerous memoirs and autobiographies by authors with epilepsy. Epilepsy now featured frequently in books and films, with a new realism and more sympathetic tone than in the past.

The pace of basic and clinical science increased dramatically in this period, boosted by an enormous increase in funding, especially in the USA. The pharmaceutical industry developed strongly and a range of new drugs were introduced for epilepsy, including ethosuximide, carbamazepine, valproate and the benzodiazepines. Pharmacokinetic principles were introduced into clinical prescribing. Specialism in medicine developed strongly and neurology took over from psychiatry as the primary specialty of epilepsy. Temporal lobe epilepsy was identified as an important form of epilepsy, the relevance of hippocampal sclerosis was recognised and temporal lobectomy was introduced. The ILAE became an important force in epilepsy with the introduction of its classification of seizure types. The ‘welfare state’ provided access to modern medical care for all patients with epilepsy for the first time in history. Institutionalisation greatly diminished. The stigma of epilepsy began to lessen in the era of liberalism and social democratic principles; social attitudes towards epilepsy greatly improved, as did the position of those handicapped by epilepsy with the disability rights movement. The patients’ voice was beginning to be heard, legislation was adopted protecting the rights of people with epilepsy, epilepsy featured in film/TV and new patient associations were formed including the IBE.