Epilepsy

Epilepsy
Other names	Seizure disorder Neurological disability
Generalized 3 Hz spike-and-wave discharges on an electroencephalogram
Specialty	Neurology
Symptoms	Periods of loss of consciousness, abnormal shaking, staring, change in vision, mood changes and/or other cognitive disturbances [1]
Duration	Long term[1]
Causes	Unknown, brain injury, stroke, brain tumors, infections of the brain, birth defects[1][2][3]
Diagnostic method	Electroencephalogram, ruling out other possible causes[4]
Differential diagnosis	Fainting, alcohol withdrawal, electrolyte problems[4]
Treatment	Medication, surgery, neurostimulation, dietary changes[5][6]
Prognosis	Controllable in 69%[7]
Frequency	51.7 million/0.68% (2021)[8]
Deaths	140,000 (2021)[9]

Epilepsy is a group of non-communicable neurological disorders characterized by a tendency for recurrent, unprovoked seizures.^[10] A seizure is a sudden burst of abnormal electrical activity in the brain that can cause a variety of symptoms, ranging from brief lapses of awareness or muscle jerks to prolonged convulsions.^[1] These episodes can result in physical injuries, either directly, such as broken bones, or through causing accidents. The diagnosis of epilepsy typically requires at least two unprovoked seizures occurring more than 24 hours apart.^[11] In some cases, however, it may be diagnosed after a single unprovoked seizure if clinical evidence suggests a high risk of recurrence.^[10] Isolated seizures that occur without recurrence risk or are provoked by identifiable causes are not considered indicative of epilepsy.^[12]

The underlying cause is often unknown,^[11] but epilepsy can result from brain injury, stroke, infections, tumors, genetic conditions, or developmental abnormalities.^[13][2][3] Epilepsy that occurs as a result of other issues may be preventable.^[1] Diagnosis involves ruling out other conditions that can resemble seizures, and may include neuroimaging, blood tests, and electroencephalography (EEG).^[4]

Most cases of epilepsy — approximately 69% — can be effectively controlled with anti-seizure medications,^[7] and inexpensive treatment options are widely available. For those whose seizures do not respond to drugs, other approaches such as surgery, neurostimulation or dietary changes may be considered.^[5][6] Not all cases of epilepsy are lifelong, and many people improve to the point that treatment is no longer needed.^[1]

As of 2021^[update], approximately 51 million people worldwide have epilepsy, with nearly 80% of cases occurring in low- and middle-income countries.^[1] The burden of epilepsy in low-income countries is more than twice that in high-income countries, likely due to higher exposure to risk factors such as perinatal injury, infections, and traumatic brain injury, combined with limited access to healthcare.^[14] In 2021, epilepsy was responsible for an estimated 140,000 deaths, an increase from 125,000 in 1990.^[9]

Epilepsy is more common in both children and older adults.^[15][16] About 5–10% of people will have an unprovoked seizure by the age of 80.^[17] The chance of experiencing a second seizure within two years after the first is around 40%.^[18][19]

People with epilepsy may be treated differently in various areas of the world and experience varying degrees of social stigma due to the alarming nature of their symptoms.^[11][20] In many countries, people with epilepsy face driving restrictions and must be seizure-free for a set period before regaining eligibility to drive.^[21] The word epilepsy is from Ancient Greek ἐπιλαμβάνειν, 'to seize, possess, or afflict'.^[22]