General Issues
WHAT IS EPILEPSY?
Epilepsy is a chronic neurological disease characterized by recurrent, unprovoked seizures. A person is considered to have epilepsy if any of the following conditions are met: 1) a person has at least two unprovoked (or reflex) seizures that occur more than 24 hours apart; 2) a person has one unprovoked seizure and it is suspected that there is a minimum of a 60% likelihood of recurrence within the next ten years; and 3) a person is diagnosed as having epilepsy syndrome. Seizures and epilepsy are not the same entity, although a seizure is the principal clinical manifestation of epilepsy, the incidence of a single seizure does not necessitate an epilepsy diagnosis. A seizure is an event in the brain that causes abnormal changes in movement, behavior, perception, or consciousness. Epilepsy is the disease which involves recurrent, unprovoked seizures.
WHAT CAUSES EPILEPSY?
Epilepsy has many causes. In some people, the cause is evident, in others unclear, and in others, the cause remains unknown. The most common causes of epilepsy vary at different stages of the life span. 1) In childhood: issues that may occur during birth such as lack of oxygen and an intracranial bleed, inborn errors such as brain malformations and genetic mutations, and infections of the central nervous system. 2) In adulthood: head trauma commonly associated with an accident while in a motor vehicle, cycling, or performing some other outdoor activity and progressive brain diseases. 3) In the elderly: stroke, brain tumor, and Alzheimer’s disease. Although this list includes a large variety of conditions which may lead to epilepsy, in approximately half of the individuals with epilepsy, the cause is unknown.
IS EPILEPSY AN INHERITED DISEASE?
Only some types of epilepsy are genetically determined, such as juvenile myoclonic epilepsy, most epilepsies are idiopathic, secondary to an unknown cause, or are secondary to one of the causes mentioned in the previous question. However, according to the Epilepsy Foundation, children of parents with epilepsy are at higher risk than the general population for developing seizures. Children whose father has epilepsy have a 2.4 percent incidence versus the 1-1.5 percent incidence of the general population. Children of mothers with epilepsy have a 4 percent incidence; the incidence is 6 to 12 percent in children who have both parents diagnosed with epilepsy.
WHAT AGE GROUPS ARE MOST AT RISK FOR EPILEPSY?
Epilepsy is the fourth most common chronic neurological disease and affects people of all ages, gender, and races. However, the elderly population is at the highest risk followed by the early childhood population. Middle age people are the least affected group by this disease. About 1 in 10 people will have a single unprovoked seizure in their lifetime and 1 in 26 people will develop epilepsy at some point in their lifetime but people with certain conditions will be at higher risk. The majority of these cases occur in the very young and in the older population. Currently, more than 3 million people are diagnosed with epilepsy in the USA. Epilepsy affects more than 65 million people worldwide.
WHAT CAUSES EPILEPTIC SEIZURES?
Epileptic seizures occur when bursts of abnormal electrical activity are generated in the brain. Normally, electrical energy is a function regulated by complex chemical changes carried out by brain cells called neurons. Neuronal misfiring results from an imbalance between excitatory and inhibitory neurons in response to abnormal chemical changes. This misfiring causes robust electrical activity to generate the seizure. The severity of the seizure is in direct proportion to the number of neurons affected; so that, the convulsion can be a focal event affecting only some parts of the body or a generalized convulsion affecting the whole brain and body.
