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 modern era of epilepsy can be said to date from around 1860. In the ensuing decades epilepsy was at the centre of an enormous range of endeavours which included Hughlings Jackson’s landmark works, the theory of cerebral localisation, the introduction of bromide and then phenobarbitone therapy and the first attempts at the surgical resection of the epileptic focus. It was the period when idiopathic epilepsy (‘genuine epilepsy’) was considered to be an inherited degenerative brain disorder, associated with mental symptoms and deficiency and a specific ‘epileptic personality’. It was the period when neurology first became a recognisable medical specialty, special hospitals for epilepsy opened and epilepsy colonies were formed all over the world. Lombroso considered epilepsy and criminality to have close connections. Inpatient treatment was conducted within the asylum system by psychiatrists. Epilepsy was associated with enormous stigma and was widely hidden or denied. In 1911, eugenics was proposed as a solution to the problems caused by epilepsy. Dostoyevsky, Zola, Dickens, Hardy and others included epilepsy in their books, and leading authors suffered from epilepsy but concealed their condition. International medical and psychiatric congresses were held, and during one of these, the International League Against Epilepsy was formed.