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According to the World Health Organization (WHO), around 50 million people currently live with epilepsy worldwide with almost 2.4 million people are being diagnosed with epilepsy each year.
New cases are detected in high-income countries that range between 30 and 50 per 100 000 people in the general population every year. However, low- and middle-income countries have this number doubled as reported by WHO (9).
People with a learning disability tend to be more vulnerable to epilepsy (5).
Idiopathic epilepsy is considered the most common type of epilepsy, affecting 6 out of 10 people diagnosed with epilepsy.
Epilepsy is more common in children or in people older than 60 years of age (5).
Epilepsy is about twice as common in children than in adults.
According to the World Health Organization (WHO), low- and middle-income countries account for 0.6%, of the global burden of disease and approximately 80% of people with epilepsy live in such countries.
People diagnosed with epilepsy are those who have abnormal electrical activity in their brain that is causing recurrent seizures. Epilepsy is classified into the following categories, focal seizures (partial) which divide into simple partial seizures and complex partial seizures. The second category is generalized seizures, which are classified as absence, tonic, atonic, clonic, myoclonic, and tonic-clonic seizures. The third category is unclassified epileptic seizures.
Most epilepsy cases are idiopathic which means that they have an unknown cause. Common causes of epilepsy may include, dementia associated diseases, traumatic brain injury, stroke, and infections such as meningitis. Some factors that may increase the risk for an individual to develop epilepsy include family history of the disease, genetics, and head trauma. Seizures that originate by excessive excitation or loss of inhibition are triggered by paroxysmal discharges from networks of neurons. Ion channels form the fundamental components of synapses, which are the key unit of neurotransmission. A malfunction associated with ion channels is considered the cause of seizures in most cases.
Symptoms of epilepsy vary from person to another. Seizures signs and symptoms may include loss of consciousness, confusion, uncontrollable jerking movements and shivering of the arms and legs. Reviewing the symptoms and medical history of the patient is necessary for a correct diagnosis.
The doctor may recommend several tests to diagnose the type of epilepsy and determine the cause of seizures such as certain blood tests and neurological examinations. Furthermore, brain abnormalities are detected via, certain tests such as electroencephalogram (EEG), magnetic resonance imaging (MRI) and computerized tomography (CT) scan.
Anti-epileptic or anti-seizure medication can be prescribed as a treatment for epilepsy, with particular concern towards their side effects. Surgery can be performed and other certain therapies can be the alternative treatment for epilepsy such as vagus nerve stimulation and ketogenic diet. Epilepsy could lead to many advanced complications including permanent brain damage, learning difficulties, and aspiration pneumonia.
Epilepsy prevention has not been proven yet, however, proper diet and sleep can be beneficial. Epidemiological facts state that approximately 50 million people currently live with epilepsy worldwide, and that epilepsy is about twice as common in children than in adults.
Epilepsy is a disorder that affects the brain. People with epilepsy have an abnormal electrical activity in their brain that causes recurrent seizures. Recurrent seizures are defined as brief episodes of involuntary movement that may sometimes be accompanied by loss of consciousness and control over bowel or bladder functions, where part of the body or the entire body may be involved.
People with epilepsy may behave strangely, express strange sensations and emotions, in addition to violent muscle spasms or loss of consciousness. Many underlying causes rather than a single diagnosis help recognize epilepsy.
Epilepsy can be classified into the following major categories:
It is limited to synapses networks of one hemisphere, widely distributed or distinctively localized. They are divided into:
These include convulsive and non-convulsive types accompanied by bilateral discharges that are associated with subcortical structures. This kind of seizures is related to distortion of the electrical activity of the whole or a large part of both sides of the brain, in addition to impaired consciousness . Six types of generalized seizures are found as follows :
These seizures may cause loss of awareness. It usually occurs in children and it is marked by staring into space or subtle body movements such as lip smacking or eye blinking. It was previously called petit mal seizures.
Muscles stiffening occurs in this type. These seizures target muscles that are located in the arms, back, and legs and may cause a person to fall to the ground.
Loss of muscle control that may lead to a sudden collapse or falling to the ground. It is also known as drop seizures.
The neck, face, and arms are usually affected by this type. Rhythmic or repeated, jerking muscle movements are related to this type of seizures.
This type causes sudden brief twitches of the arms and legs.
Sudden loss of consciousness, muscles stiffening and shaking, biting the tongue, and sometimes loss of bladder control are often seen in this type. It was previously called grand mal seizures and is considered the most severe of all types of generalized seizures.
This category is used when none of the description mentioned above matches the case.
Epilepsy is caused by abnormal activity in the cells of the brain. Most epilepsy cases are idiopathic which means that the cause is unknown. Common causes of epilepsy may include:
The risk of having epilepsy is increased by the following:
When the family history contains cases of epilepsy, the possibility of developing seizure disorder is increased.
Having a parent or a sibling who has developed epilepsy can increase the possibility of epilepsy.
Epilepsy can result from critical head injuries and in some cases, even years after the injury has occurred.
Such as Alzheimer's disease, stroke, brain tumors, or problems with the blood vessels in the brain all can increase the possibility of epilepsy.
Infectious diseases such as meningitis, encephalitis, and AIDS can increase the possibility of having epilepsy.
Epilepsy is more common during early childhood and after age 60; however, it can occur at any age.
Infections during pregnancy, congenital brain defects or injury to an infant's central nervous system increase the incidence of epilepsy.
Seizures that originate by excessive excitation or loss of inhibition are triggered by paroxysmal discharges from networks of neurons. Ion channels form the fundamental components of synapses which are the key unit of neurotransmission; are the junction point where one neuron communicates with the other. A malfunction associated with ion channels is considered the cause of seizures in most cases. When these channels are involved, genetic abnormalities are responsible for one-third of seizure cases. Structural lesions cause a quarter or so of seizures, in addition to other neurological abnormalities that could be present in people suffering from these lesions.
Environmental factors can majorly contribute to some of these lesions, such as traumatic brain injury, perinatal brain lesions, infections, and brain tumors. Other factors are genetic predisposition or highly related to a genetic component such as metabolic disorders, genetic tumor syndromes, and brain malformations. No genetic or structural abnormality relation is reported in about half of the seizure disorders. Nevertheless, it is possible that genetic or acquired channelopathies, which are not yet recognized, could be responsible for many of these cases.
However, synapse development, genes, and environment strongly influence seizures. Seizures are categorized into generalized, focal, and several special epileptic syndromes based on the pattern of the attack.
Symptoms are variable from one individual to another but mainly epilepsy is manifested in seizures. Seizure signs and symptoms may include:
Reviewing the symptoms and medical history of the patient, in addition to requesting several tests are necessary to complete a correct diagnosis and in defining the lying reason behind seizures. These tests include:
A blood sample is needed to check the genetic conditions and signs of infections, in addition to other possible conditions that may be related to seizures.
Examining behavior, motor abilities, and mental function are conducted in order to diagnose the condition and determine the type of epilepsy the patient has.
Brain abnormalities can be detected using these tests :
The electrical activity of the brain is record via attaching electrodes to the scalp with a paste-like substance. This test is the most commonly used in diagnosing epilepsy. Abnormal brain activity is detected in people with epilepsy even when they are not having seizures through this technique. A patient is asked to do seizure triggering actions prior to the test in order to record the seizure while the patient is awake or asleep.
Using powerful magnets and radio waves, MRI will help in creating a detailed view of the brain, where lesions or abnormalities can be detected using this test which could be the cause of epilepsy.
Variations in the blood flow that occur when particular regions of the brain are working can be seen in this test. The precise location for critical functions is determined through this test prior to surgery to avoid damaging these locations.
X-rays are used to get cross-sectional images of the brain which reveals brain abnormalities such as tumors, bleeding and cysts that might be responsible for seizures.
If MRI and EEG are unable to specify the location in the brain where the seizures are originating SPECT is used to determine the specific location by creating 3-D map of the blood flow activity in the brain during a seizure. This is done via the injection of a small amount of low-dose radioactive material into a vein. The subtraction ictal SPECT coregistered to magnetic resonance imaging (SISCOM) is able to give a more detailed 3-D map
It helps in visualizing the active regions of the brain and in detecting abnormalities by using a small amount of low-dose radioactive material that is injected into a vein.
Neuropsychological tests
An assessment of a patient’s method of thinking, memory and speech skills is done. The doctor will be able to determine the affected areas of the brain.
Medications are the first option in the treatment of epilepsy. When medications are incapable of treating the condition, doctors may consider surgery or another available treatment.
There are around 26 anti-epileptic drugs available that treat seizures, each one of these drugs can be prescribed to treat a particular kind of seizures. Anti-epileptic drugs for generalized tonic-clonic seizures include valproate, lamotrigine, and topiramate. Anti-epileptic drugs for partial seizures include carbamazepine and oxcarbazepine.The doctor may prescribe one anti-epileptic or anti-seizure medication with a particular concern towards the side effects that range from mild to severe that may include:
Surgery is performed in order to remove particular areas of the brain which are proven to be responsible for seizures. Surgery complications include permanent altering of cognitive abilities in a small number of cases.
Therapies used to treat epilepsy, including the following:
Though the mechanism is still not well understood, a device called a vagus nerve stimulator is implanted underneath the skin of the chest which that will reduce seizures by 20 to 40 percent. It is used when a patient’s case is unmanageable by anti-epileptic medication but still is suitable for resective surgery.
A strict diet that is high in fats and low in carbohydrates can reduce seizures in some children with epilepsy.
If not treated, epilepsy could lead to many advanced complications such as :
Other uncommon life-threatening complications that are associated with epilepsy include:
This case happens when an individual suffers from recurrent seizures without regaining full consciousness between these episodes or has prolonged seizure for more than 5 minutes. Permanent brain damage and death are expected consequences in this condition.
People who suffer from epilepsy face a small risk of sudden unexplained death. The exact reason behind such cases is still undetermined; suggestions owe it to contributions from the heart or respiratory conditions.
There is no scientifically proven method to prevent epilepsy. The possibility of having a seizure in people with epilepsy can be reduced by following a proper diet and getting the correct amount of sleep, in addition to avoiding alcohol and illegal drugs.
There is no definite cure for epilepsy. Medication, diet, devices, and/or surgery could control epilepsy.Continues uncontrolled seizures may cause brain damage unlike the majority of seizures that do not cause brain damage.
Specific types of epilepsy seen among children can come to recovery with age, usually in the late teens or 20s.
In some cases, epilepsy can be a life-threatening condition. Abnormally prolonged seizures or sudden unexplained death in epilepsy are possible in some people with epilepsy.
Premature death is common in adults with epilepsy compared to the general population. Reports indicate that the majority of these deaths happen in people under 55 years of age. Suicide is a leading cause of premature mortality in adults with epilepsy. Suicide rates in people with epilepsy are reported to be three times higher than those in the general population.
According to the World Health Organization (WHO), around 50 million people currently live with epilepsy worldwide with almost 2.4 million people are being diagnosed with epilepsy each year.
New cases are detected in high-income countries that range between 30 and 50 per 100 000 people in the general population every year. However, low- and middle-income countries have this number doubled as reported by WHO (9).
People with a learning disability tend to be more vulnerable to epilepsy (5).
Idiopathic epilepsy is considered the most common type of epilepsy, affecting 6 out of 10 people diagnosed with epilepsy.
Epilepsy is more common in children or in people older than 60 years of age (5).
Epilepsy is about twice as common in children than in adults.
According to the World Health Organization (WHO), low- and middle-income countries account for 0.6%, of the global burden of disease and approximately 80% of people with epilepsy live in such countries.
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