Conclusions

As the account by Temkin makes abundantly clear, epilepsy is not a static entity–time and place matter. If basic science, clinical and social developments occur as rapidly over the next 60 years as over the last, the epilepsy landscape will likely be a very different one by the year 2070. We asked our contributors not only to reflect back over the last 60 years, but also to think forward and speculate on how things might be by the time Epilepsy Action reaches its 120th birthday! How might the 'gaze' on epilepsy change? As the articles Engel highlight, in 2010 we are able to see the brain as never before, opening up huge possibilities for management of seizures and epilepsy in the future. Yet despite such profoundly important developments, Mark Rees reminds us that research has so far failed to uncover a common epilepsy gene; and Martin Brodie that choice of drug treatment remains largely a matter of guesswork and we still have a long way to go to achieve truly rational management. Financial, as well as scientific, limitations mean, as highlighted by Bert Aldenkamp and Helen Cross, that there is and will likely continue to be a lack of choice for patients over provision of their care and the nature of their treatment options; and as Hanneke de Boer and Philip Lee amply illustrate, misinformation and misrepresentation of what epilepsy is and is not continues to limit the lives and opportunities of people with epilepsy in ways that are both unnecessary and unacceptable. Not surprising, then, that the 'wish lists' for the future set out by Madelin Bexon and Steven Schachter are quite lengthy ones! New knowledge demands new strategies. In a recently published and highly erudite article, Milton 1 observes that there is, currently, a 'formidable barrier separating clinical epileptolo-gists, on the one side, and computational neuroscientists, on the other', in which both sides – and, ultimately, people with epilepsy – lose. Milton argues that it is now possible to use mathematical modelling to propose experimentally testable predictions about what is 'fundamentally a dynamic disease'; and concludes that new and more effective treatment strategies will most likely be realised when clinicians and modellers come together in interdis-ciplinary teams. Commenting, Osorio 2 concludes that Milton's approach offers the possibility of insights into epilepsy that have so far eluded traditional clinical methods. As non-mathematicians and non-epileptologists, we make no claim to …