An Episode in the History of Temporal Lobe Epilepsy: The Quadrennial Meeting of the ILAE in 1953

On September 7, 1953, the quadrennial meeting of the ILAE was held in Lisbon, as was customary at that time in association with the International Neurological Congress. In those days, the congress of the League was a singleday affair, and on this occasion, was devoted entirely to the subject of the temporal epilepsies. This was a landmark meeting in the evolution of thought on temporal lobe epilepsy. The subject had only begun to attract research or clinical attention in the preceding 5 years, and the Lisbon meeting had the effect of placing it firmly at the center of contemporary clinical and research interest. As this issue of Epilepsia is also focused on temporal lobe epilepsy, it seemed timely to devote an historical note to the Lisbon meeting and to reflect on where knowledge has advanced (or not) in the half-century since the Lisbon congress was held. The meeting was conceived and convened by Henri Gastaut, the new ILAE President-elect, who had by his own admission devoted all his activities in the previous 5 years to the study of the temporal epilepsies. The meeting took an interesting form, and perhaps one that the ILAE might consider resuscitating. It consisted primarily of a consideration of a detailed manuscript, written by Gastaut, and entitled So-called “Psychomotor” and “Temporal” Epilepsy. The manuscript was precirculated to 20 important figures in the field (discussants), who sent in written commentaries and some of whom also attended the meeting. The manuscript and the discussants’ written comments were then presented at the meeting for open discussion. The original manuscript and commentaries were published in Epilepsia (1) and make fascinating reading. These 1953 Epilepsia articles were very influential, defining the direction and scope of research in this area for the next few decades and mapping out issues that still remain topical today. Indeed, the spirit of this earlier meeting can still be detected stalking the pages of this current issue of Epilepsia. Gastaut’s article is an impressive work. After an introduction and historical review, the article is divided into a six sections, which Gastaut called critical studies. These were summaries of contemporary knowledge augmented by Gastaut’s own data, and covered the following areas: clinical symptoms; electroencephalographic symptoms; correlations between the clinical and electroencephalographic symptoms; surgical anatomical findings; pathogenesis; and methods of treatment. The article was then concluded by a review of experimentally induced attacks of psychomotor or temporal epilepsy. One emphasis of the article is, as one would expect from the period and the author, on classification and terminology. The relative merits of the terms psychomotor and temporal seizures were debated, and as Merlis in his closing remarks acutely observed: