Epilepsy

What is Epilepsy?

Epilepsy appeared in Indian and Babylonian medical texts dating back to 4500 b.c.e., with its name coming from the Greek word epilambanein meaning “to at-tack/seize.” The experience of a seizure was believed to be the result of supernatural forces, cycles of the moon, or spiritual possession. In modern times, the causes of epilepsy although not well understood include genetics, brain disease, substance abuse, parasites, febrile illness, and head injury/trauma.

Not until the 17th and 18th centuries was epilepsy viewed as a medical disorder, and not until the establishment of the field of neurology was it thought of as a brain disorder. Epilepsy affects the brain through excessive release of neurons causing seizures that take on various forms based on the location and size of the area(s) affected. Generalized/grand mal seizures are characterized by loss of consciousness and muscle stiffness and contraction. A variation on this are petit mal seizures usually with shorter periods of unconsciousness. The second type of seizure is partial or focal, which start in one part of the brain and can spread to other parts, leading to generalized seizures. Partial seizures may result in brief losses of attention or longer periods of mental absence. The third type, status epilepticus is characterized by frequent seizures without recovery, which if not treated can lead to brain damage or death. It is not well understood why people experience certain types of seizures, but triggers for their onset have been identified, including flashing lights, physical exertion, lack of sleep, or stress.

For most people with epilepsy, experiencing seizures is sporadic, but the psychosocial consequences continually influence quality of life.

Epidemiology of Epilepsy

Although epilepsy does not discriminate based on sociodemographic characteristics, most diagnoses occur among infants, adolescents, and older adults. According to the World Health Organization (WHO), approximately 8.2 per 1,000 (50 million) people currently live with active epilepsy (experience reoccurring seizures or are in need of treatment). Developing nations have a much higher incident rate with 100 per 100,000 compared to 50 in developed nations. People with epilepsy have an increased risk of mortality attributed to underlying brain disease (i.e., tumor), having seizures at dangerous times (i.e., while swimming, driving, etc.), status epilepticus, respiratory failure during seizures, and suicide.

Psychosocial Consequences

The psychosocial consequences of living with epilepsy can drastically influence a person's quality of life. The psychological consequences include increased rates of mood and anxiety disorders, with the most common being depression and dysthymia. The underlying reasons for this are not well understood and have been attributed to the influence of epilepsy on the brain, anti-epileptic medications, disruptions in sleep, social factors, or various combinations. Anxiety is also more prevalent among people with epilepsy, characterized by feelings of fear, dread or uneasiness, and sometimes tied to the seizure experience or the result of not knowing when the next seizure will occur.

...