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Intractable epilepsy

Epilepsy
Synonyms Seizure disorder
An electroencephalogram of a person with childhood absence epilepsy showing a seizure. The waves are black on a white background.
Generalized 3 Hz spike-and-wave discharges on an electroencephalogram
Specialty Neurology
Symptoms Periods of vigorous shaking, nearly undetectable spells
Duration Long term
Causes Unknown, brain injury, stroke, brain tumors, infections of the brain, birth defects
Diagnostic method Electroencephalogram, ruling out other possible causes
Similar conditions Fainting, alcohol withdrawal, electrolyte problems
Treatment Medication, surgery, neurostimulation, dietary changes
Prognosis Controllable in 70%
Frequency 39 million / 0.5% (2015)
Deaths 125,000 (2015)
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Classification
External resources

Epilepsy is a group of neurological disorders characterized by epileptic seizures. Epileptic seizures are episodes that can vary from brief and nearly undetectable to long periods of vigorous shaking. These episodes can result in physical injuries including occasionally broken bones. In epilepsy, seizures tend to recur and as a rule, have no immediate underlying cause. Isolated seizures that are provoked by a specific cause such as poisoning are not deemed to represent epilepsy. People with epilepsy in some areas of the world experience stigma due to the condition.

The cause of most cases of epilepsy is unknown. Some cases occur as the result of brain injury, stroke, brain tumors, infections of the brain, and birth defects, through a process known as epileptogenesis. Known genetic mutations are directly linked to a small proportion of cases. Epileptic seizures are the result of excessive and abnormal nerve cell activity in the cortex of the brain. The diagnosis involves ruling out other conditions that might cause similar symptoms such as fainting and determining if another cause of seizures is present such as alcohol withdrawal or electrolyte problems. This may be partly done by imaging the brain and performing blood tests. Epilepsy can often be confirmed with an electroencephalogram (EEG), but a normal test does not rule out the condition.

Epilepsy that occurs as a result of other issues may be preventable. Seizures are controllable with medication in about 70% of cases. Inexpensive options are often available. In those whose seizures do not respond to medication, then surgery, neurostimulation, or dietary changes may be considered. Not all cases of epilepsy are lifelong, and many people improve to the point that treatment is no longer needed.


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