Epilepsy in children and young people as a stigma throughout history: identifying cultural, religious and educational factors to design strategies for contemporary social inclusion.

Epilepsy ranks among the most extensively stigmatized neurological conditions in recorded history, affecting an estimated 50 million people worldwide. This paper examines the historical transformation of stigma associated with epilepsy in children, adolescents, and young adults across cultural and chronological contexts ranging from Mesopotamian antiquity to the digital present. A qualitative design was employed in which a critical narrative review of the scholarly literature furnished the basis for a historical-critical analysis of primary sources. Medical texts, religious writings, and legal documents were treated as the core material wherever they survived from the period under study, while the secondary literature-chiefly peer-reviewed studies, together with monographs and institutional reports-retrieved from databases including JSTOR, PubMed, Scopus, and Web of Science, and selected according to explicit inclusion and exclusion criteria focused on the social, cultural, religious, and educational dimensions of epilepsy in younger populations, served to identify and contextualize those sources and to situate them within existing interpretation. As an example of the depth of engagement with primary sources, the article presents an interdisciplinary analysis of one of the earliest semiologically precise literary descriptions of a childhood epileptic seizure-found in Mk 9:14-27-through a methodological convergence that combines, among other fields, philological studies, the direct analysis of original-language sources, the critical examination of manuscripts from scholarly critical editions, the social sciences applied to the study of history, and contemporary epileptological semiology, a combination rarely attempted in this literature. Across the various historical periods examined, recurring patterns of stigmatization have been identified, grounded in supernatural etiological frameworks, moral attribution, and persistent misconceptions about the nature and transmissibility of the condition. A central and undertheorized finding is the systematic ambivalence in the social valence of epileptic stigma: seizures interpreted among the socially marginal as demonic possession or divine punishment were, by the same cultural logic, recast among the powerful and the spiritually elevated as marks of divine election or charismatic predestination. This status-contingent inversion of stigmatic valence recurs across cultures and epochs. A related finding is that ideologically grounded stigma-most starkly, the eugenic doctrines of the nineteenth and twentieth centuries-proved more socially destructive in certain historical contexts than stigma of religious origin, precisely because it purported to rest on scientific authority, undermining the assumption that neurological knowledge alone attenuates stigma, which is in reality shaped by a broader range of factors. The findings underscore that the persistence of stigma is attributable primarily to complex sociohistorical processes implicating power and ideology, deeply rooted cultural traditions, the instrumentalized use of religion, and educational exclusion. Understanding these processes from a historical perspective is the necessary foundation for designing culturally sensitive strategies to promote social inclusion and reduce discrimination against children and young people living with epilepsy.