Epilepsy

Epilepsy is any condition where a person suffers from seizures or fits. 1 out of 200 people or .5% of the population have one of these conditions. It is common in childhood as 5% of children under 12 are diagnosed.  It also strikes many people over the age of 65 but it can occur to anyone at any point in time. Nearly 2/3 new cases are discovered in developing countries. Not all epilepsy syndromes are lifelong, some types are confined to particular stages of childhood. There are also different causes of epilepsy that are common among certain age groups. The seizure episodes can be a harmless accompaniment to an acute fever or illness. There are recurring types where the the seizures start and cease spontaneously due to sudden, rapid discharge of nerve cells into the cortex. Epileptic seizures can also result in recovering patients as a consequence of brain surgery. Likewise tumors, stroke, injury and infection in the brain can also be underlying causes.

Diagnosis is based on observing clinical symptoms although seizures occur spontaneously. In regards to treatment the goal has only been an attempt to control the seizures with anticonvulsant medications. However, over 30% of people with epilepsy do not have seizure control even with the best available medications. Epilepsy should not be understood as a single disorder, but rather as vastly divergent in symptoms but all involving episodic & abnormal electrical activity in the brain.

Certain epilepsy syndromes require particular precipitants or triggers for seizures to occur. These are termed reflex epilepsy. For example, patients with primary reading epilepsy have seizures triggered by reading. Photosensitive epilepsy can be limited to seizures triggered by flashing lights. Children with childhood absence epilepsy may be susceptible to hyperventilation. Even the menstrual cycle in women with epilepsy can influence patterns of seizure recurrence. Flashing lights and hyperventilation are actually activating procedures used in clinical EEG to help trigger seizures to aid diagnosis. Other precipitants can facilitate, rather than directly trigger seizures in susceptible individuals. Emotional stress, sleep deprivation, sleep itself, heat stress, alcohol and illness during pregnancy are examples of precipitants cited by patients. Notably, the influence of various precipitants varies with each different epilepsy syndrome.

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