Chemistry of Anticonvulsant Drugs

Speculation as to the mechanism of convulsive attacks has been common since the dawn of scientific medicine. The assumption, so widespread in the last century, that epilepsy is a hereditary and constitutional disorder, without demonstrable structural abnormality, implies a chemical basis for the disease. This conception has received recent statistical confirmation.1 Modern methods of investigation have, to be sure, revealed structural abnormalities of the cerebral cortex in an increasing proportion of cases of epilepsy.2Even when such an abnormality exists, however, to say that it isthe"cause" of the attacks is seriously to underestimate the importance of the underlying constitutional factor. Structural defects, such as scars or tumors, are unaccompanied by convulsions in the majority of instances. The incidence of blood relatives subject to convulsions in cases in which seizures appear after an injury is almost as high as in those cases in which no injury is