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Summary John Hughlings Jackson is widely credited with the first electrical theory of epilepsy (1873), which was confirmed by the experimental studies of Hitzig and Ferrier. His views are summarised in his famous Lumleian lectures to the Royal College of Physicians in 1890. Robert Bentley Todd, however, had earlier developed an electrical theory of epilepsy, which he presented in his own brilliant Lumleian lectures to the Royal College of Physicians in 1849. Todd was influenced by the electrical discoveries of his contemporary, Michael Faraday, and thought of the brain as having battery like properties that led to the sudden discharge of electrical energy (nervous force) in epilepsy. Unlike Hughlings Jackson, Todd was an anatomist and physiologist as well as a physician, and he did his own electrical experiments in rabbits to prove his theory, something Hughlings Jackson, who relied on Ferrier for scientific and experimental support, could never have done. There is no mention of Todd's Lumleian lectures in Hughlings Jackson's later lectures and writings, nor in those of Hitzig or Ferrier. Todd's remarkable observations and lectures, and his electrical theory of epilepsy deserve to be drawn to the attention of the medical and scientific community.

The difficulties of the drug treatment of epilepsy include the high prevalence of the disorder, poor prognosis, prolonged multidrug treatment, chronic toxicity, and uncertainty of the relative efficacy and toxicity of individual anticonvulsants. These problems are reviewed in relation to recent knowledge of the clinical pharmacology of the drugs, the application of which offers the possibility of a more simple, rational, and effective approach to therapy. There is considerable potential for monotherapy assisted by druglevel monitoring.

S-adenosylmethionine (SAM) has antidepressant properties. The commonest neuropsychiatric complication of severe folate deficiency is depression. These independent observations suggest that methylation in the nervous system may underlie the expression of mood and related processes and may be implicated in some affective disorders; suggest new biological approaches to the understanding and treatment of some affective disorders; and may explain why methionine sometimes aggravates schizophrenia.

Community-based and our own hospital-based studies suggest that the prognosis for seizure control is very good in most patients with epilepsy. However, chronic epilepsy develops in about 25%. The pattern of chronicity is established early in the course of treatment. Factors associated with a high risk of chronicity include additional neurological, psychological, and social handicaps and also partial seizures. In addition a process of evolution of chronic epilepsy may occur by a mechanism proposed by Gowers a century ago. Chronic epilepsy is very difficult to control and may best be prevented by more effective treatment at the onset of the disorder.