Around 50 million people worldwide suffer from epilepsy, a chronic noncommunicable brain condition. Recurrent seizures are its defining feature. Seizures are brief bursts of spontaneous movement that might affect either a portion of the body (partial) or the entire body (generalized), and they can occasionally be followed by loss of consciousness and control over bowel or bladder function.
Excessive electrical discharges in a cluster of brain cells cause seizure episodes. Such discharges can occur in various areas of the brain. The smallest muscular jerks or attention lapses can be seizures, as well as severe convulsions that last for a long time. The frequency of seizures can also vary, from fewer than one per year to several per day.
Up to 10% of people worldwide experience one seizure in their lives, thus having one does not necessarily indicate epilepsy. Two or more unprovoked seizures are considered to be an epileptic seizure. Written accounts of epilepsy date as far back as 4000 BCE, making it one of the oldest documented medical diseases in the world. Epilepsy has been shrouded in fear, misinformation, prejudice, and social shame for millennia. The quality of life for those who have the condition and their family may be negatively impacted by this stigma, which persists in many nations today.
Important information
- All ages are affected by the chronic, noncommunicable brain disorder known as epilepsy.
- Epilepsy affects about 50 million individuals worldwide, making it one of the most prevalent neurological conditions worldwide.
- People with epilepsy make up over 80% of the population in low- and middle-income nations.
- According to estimates, 70% of epilepsy sufferers could avoid seizures if their condition was adequately identified and treated.
- Up to three times as often as the general population, epilepsy patients are at risk of dying before their time.
- In low-income nations, 75% of epilepsy sufferers do not receive the necessary care.
- People with epilepsy and their families encounter stigma and discrimination in many parts of the world.
Symptoms and signs
Seizures can have a variety of characteristics, depending on where in the brain the disruption first appears and how far it develops. Temporary symptoms include loss of awareness or consciousness as well as impairments in movement, mood, or other cognitive processes, as well as changes of sense (including vision, hearing, and taste).
Both physical issues (such as fractures and bruising from seizures-related traumas) and psychological issues, such as anxiety and sadness, are more common in people with epilepsy. Similar to this, patients with epilepsy have a risk of dying prematurely that is up to three times higher than that of the general population, with rural areas and low- and middle-income countries having the highest rates of early mortality.
Many of the epilepsy-related causes of death, particularly in low- and middle-income nations, can be avoided, including falls, drowning, burns, and extended seizures.
Disease prevalence
A large amount of the global disease burden is accounted for by epilepsy, which affects about 50 million individuals globally. Between 4 and 10 per 1000 people are thought to be affected by active epilepsy at any given moment, defined as having ongoing seizures or needing treatment.
Each year, epilepsy affects an estimated 5 million people worldwide. Epilepsy is thought to be diagnosed in 49 out of every 100,000 people annually in high-income countries. This number can reach 139 per 100 000 in low- and middle-income nations. This is probably because endemic diseases like malaria and neurocysticercosis are more common, road traffic accidents and birth injuries are more common, and there are differences in the medical infrastructure, the availability of preventative health programs, and access to care. Nearly 80% of epilepsy sufferers reside in low- and middle-income nations.
Causes
Epilepsy cannot be spread. Though various underlying diseases can cause epilepsy, in roughly 50% of cases around the world the disease’s origin is still unknown. The following subcategories of causes of epilepsy exist: structural, genetic, infectious, metabolic, immunological, and unknown. Examples comprise:
- Brain damage due to perinatal or fetal factors (such as low birth weight, trauma during delivery, or oxygen depletion during birth);
- Brain deformities caused by congenital anomalies or hereditary diseases;
- Significant brain damage;
- A stroke in which the flow of oxygen to the brain is restricted;
- A brain infection, such as neurocysticercosis, encephalitis, or meningitis,
- A brain tumor; and a few hereditary disorders.
Treatment
Seizures are manageable. With the proper administration of antiseizure medications, up to 70% of patients with epilepsy could go seizure-free. After two years without seizures, stopping anti-epileptic medication may be an option, but it should be done with consideration for pertinent clinical, social, and private issues. The two most reliable indicators of seizure recurrence are a known etiology for the seizure and an abnormal electroencephalography (EEG) pattern.
About 75 percent of epileptic patients may not obtain the necessary care in low-income nations. The “treatment gap” refers to this.
Anti-seizure medications are not widely available in many low- and middle-income nations. According to a recent study, less than 50% of generic antiseizure medications are typically available in the public sector of low- and middle-income nations. This can make it difficult to get treatment.
Most epileptic patients can be diagnosed and treated at the basic healthcare level without the need for advanced technology.
According to WHO pilot studies, teaching primary healthcare practitioners how to recognize and treat epilepsy can significantly close the treatment gap for the condition.
Patients who respond poorly to pharmacological therapies may benefit from surgery.
Prevention
A quarter of epilepsy cases are thought to be avoidable.
- The most efficient strategy to prevent post-traumatic epilepsy is to minimize head injury, for instance by lowering falls, auto accidents, and sports injuries.
- Proper prenatal care can lower the number of new instances of epilepsy brought on by birth trauma.
- The risk of febrile seizures can be decreased by using medications and other techniques to lower a sick child’s body temperature.
- The reduction of cardiovascular risk factors, such as actions to prevent or control high blood pressure, diabetes, and obesity, as well as abstaining from cigarettes and excessive alcohol consumption, is the main goal of the prevention of epilepsy linked with stroke.
- Epilepsy is frequently brought on by central nervous system illnesses in tropical regions, which are primarily inhabited by low- and middle-income nations. The prevalence of epilepsy, such as those brought on by neurocysticercosis, can be decreased globally by the elimination of parasites in these environments and education about how to prevent infections.
