Epilepsy overview
Epilepsy, also known as ‘seizure disorder’, is a medical condition in which the brain experiences intense surges of electrical activity of definite types.¹ This produces seizures which affect a variety of mental and physical functions, such as consciousness, body movements, and sensations.² People with epilepsy can generally live normal lives; however, they must take precautions to reduce the risk of injuring themselves during seizures.³

Epilepsy can be caused by many medical conditions, from genetic mutations to traumatic brain injury.⁴ More often than not, no cause can be identified.¹

Symptoms
There are many types of seizure, varying from brief disruptions of the senses, to short periods of unconsciousness, to convulsions.^2,5 Some symptoms of seizures are not easily recognised by the person experiencing them or by healthcare professionals. These lesser-recognised symptoms can include blank staring, lip smacking, or jerking movements of arms and legs.⁵

A person is considered to have epilepsy when they have experienced two or more unprovoked seizures.² It is important to note that all people with epilepsy will have seizures, but not all people with seizures will necessarily be diagnosed with epilepsy.⁶

Statistics
It is estimated that 1% of people aged 20 years have epilepsy, and 3% of people aged 75 years.⁷ Ten per cent of people will have at least one seizure in their lifetime.⁷ According to the Epilepsy Foundation of America, almost 3 million Americans have experienced epilepsy and seizures.⁷ Worldwide, 40 million people have epilepsy.⁸

Epilepsy can occur in people of all ages and races.¹ Approximately 200,000 new cases of epilepsy are diagnosed each year, and diagnosis is most common in the age groups of under two years and over 65 years.⁷

In the US, the annual direct and indirect costs of epilepsy are estimated at $17.6 billion.⁷

Seeking diagnosis and care
If the symptoms of epilepsy are experienced, the condition can be diagnosed and managed by many types of doctors, including neurologists, paediatric neurologists, paediatricians, neurosurgeons, internists and family physicians, depending on the local medical practice and regulations.¹

Diagnosis is a multi-step process that includes a review of medical history, a physical examination, tests to analyse blood and other bodily fluids, electroencephalography (EEG), and brain imaging techniques.⁹ The precise tests and diagnostic tools that are used will vary.⁹

Following diagnosis of seizures or epilepsy, the next step is to select the appropriate treatment.¹⁰ There is no cure for epilepsy,⁵ but seizures can be prevented with regular use of appropriate medications.¹⁰ If drugs are unsuccessful, alternative options include surgery, a special diet, complementary therapy or stimulation of the vagus nerve.¹⁰ Surgery can prevent seizures that are caused by an underlying correctable brain condition.¹⁰

All types of treatment for epilepsy should only be received following professional medical advice.

References

1. Epilepsy Foundation. Frequently asked questions. www.epilepsyfoundation.org/aboutepilepsy/faq.cfm. Accessed 05/09/11.

2. Epilepsy Foundation. About epilepsy. www.epilepsyfoundation.org/aboutepilepsy/index.cfm. Accessed 05/09/11.

3. Epilepsy Foundation. Health risks. www.epilepsyfoundation.org/aboutepilepsy/healthrisks/index.cfm. Accessed 05/09/11.

4. RogersSJ, Cavazos JE. Epilepsy. In: DiPiro JT, Talbert RL, Yee GC, et al., eds. Pharmacotherapy: A pathophysiologic approach. 7^th edition.New York,NY: McGraw-Hill; 2008: p927.

5. Epilepsy Foundation. What is epilepsy? www.epilepsyfoundation.org/livingwithepilepsy/youth/youngadults/what-is-epilepsy.cfm. Accessed 05/09/11.

6. Lowenstein DH. Seizures and epilepsy. In: Fauci AS, Braunwald E, Kasper DL, et al., eds. Harrison’s Principles of Internal Medicine. 17^th edition.Philadelphia,PA: McGraw Hill; 2010: p1.

7. Epilepsy Foundation. Incidence and prevalence. www.epilepsyfoundation.org/aboutepilepsy/whatisepilepsy/statistics.cfm. Accessed 05/09/11.

8. World Health Organization. The global burden of disease. 2004 update. www.who.int/healthinfo/global_burden_disease/2004_report_update/en/index.html. Accessed 06/09/11.

9. Epilepsy Foundation. Diagnosis. www.epilepsyfoundation.org/aboutepilepsy/Diagnosis/index.cfm. Accessed 05/09/11.

10. Epilepsy Foundation. Treatment. www.epilepsyfoundation.org/aboutepilepsy/treatment/index.cfm. Accessed 05/09/11.