Epilepsy is a common chronological neurological condition, which affects the nervous system. It is usually controlled, but not cured, with medication, although surgery may be considered in difficult cases. Epilepsy is also known as a seizure disorder. It is usually diagnosed after a person has had at least two seizures (convulsions) that were not caused by some known medical condition like alcohol withdrawal or extremely low blood sugar. The seizures in epilepsy may be related to a brain injury or a family tendency, but most of the time the cause is unknown. The word "epilepsy" does not indicate anything about the cause of the person's seizures, what type they are, or how severe they are.

WHAT CAUSES EPILEPSY?

The reasons why epilepsy begins are different for people of different ages. But what's true for every age is that the cause is unknown for about half of everyone with epilepsy. Children may be born with a defect in the structure of their brain, or they may suffer a head injury or infection that causes their epilepsy. Severe head injury is the most common known cause in young adults. In middle age, strokes, tumors, and injuries are more frequent. In people over 65, stroke is the most common known cause, followed by degenerative conditions such as Alzheimer's disease. Often seizures do not begin immediately after a person has an injury to the brain. Instead, a seizure may happen many months later.

DIAGNOSIS

Diagnosing seizures and the type of epilepsy is like putting the pieces of a puzzle together and includes information from many people and different tests. The first question is to find out if the person had a seizure, then the doctor will want to know the type of seizure or epilepsy syndrome that best explains the event. To do this, more information will be needed, including details of the medical history, blood tests, EEG tests, and brain imaging tests such as CT and MRI scans. This gives information about the electrical activity of the brain, what the brain looks like and possible causes of seizures. This information is put together with how the individual is feeling and how the seizures may be affecting the way the brain works.

WHO GETS EPILEPSY?

Epilepsy can develop in any person at any age. About 1 in every 200 people has epilepsy; according to Epilepsy South Africa. People with certain conditions may be at greater risk. More men than women have epilepsy. New cases of epilepsy are most common among children, especially during the first year of life. The rate of new cases gradually declines until about age 10, and then becomes stable. After age 55 or 60, the rate starts to increase, as people develop strokes, brain tumors, or Alzheimer's disease. (All of these disorders can cause epilepsy.)

Knowing what to do when a person is having a seizure is an important part of treatment. But taking a longer view, the real objective of treating epilepsy is to stop seizures or control them as best as possible, and to help people with seizures to lead a full and unrestricted life according to their own wishes. "No seizures, no side effects" is the motto for epilepsy treatment. Not every person will achieve that goal right now, but with more research more will achieve it each year. Many people may have the possibility of achieving better seizure control right now, but haven't gotten the help they need.

The more medicines that are unable to control your seizures, however, the less likely it is that another medication regimen will fully succeed. Other kinds of treatments, such as vagus nerve stimulation or epilepsy surgery, may be very helpful for some people who continue to have seizures while taking seizure medicines. The good news is that treatments are available that can successfully prevent seizures for most people with epilepsy.

More information on epilepsy can be found on the Epilepsy SA website