Fish soup for the falling sickness: Tracing epilepsy through Hmong and Western beliefs

•Spiritual theories in Western antiquity ascribed seizures to sin and possession.•Seizures in Hmong culture reflect elevated levels of spirituality.•In Hmong culture, persons with epilepsy (PWE) are often a source of pride for a family.•Stigma affecting PWE remains.•This history may have present-day implications as it pertains to stigma. Hmong communities originated in China but today are located across the globe. Salvation, health, and well-being in Hmong tradition are contingent upon pleasing spirits and ancestors. While most diseases are believed to reflect the displeasure of spirits and ancestors, epilepsy is unique in that it portends a heightened capacity for achieving an elevated level of spirituality, which has led it to be deemed honorable by Hmong society members. This stands in stark contrast to some contexts within which epilepsy has been historically understood in the West in which the disease was believed to originate from sin and evil. If and how societal response toward persons with epilepsy (PWE) in Hmong communities differ from that in other Western communities in a way that parallels these differences in beliefs regarding the etiology and significance of the seizures is unknown. Understanding this may have implications that guide efforts in combatting stigma affecting PWE.