Editing Epilepsy (section)

{{Short description|Group of neurological disorders causing seizures}}
{{Redirect2|Epilepsia|Epileptic|the journal|Epilepsia (journal)|the comics|Epileptic (comics)}}
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{{Use dmy dates|date=February 2023}}
{{Infobox medical condition (new)
| name = Epilepsy
| synonyms = Seizure disorder<br>
Neurological disability
| image = Spike-waves.png
| alt = The electroencephalogram recording of a person with childhood absence epilepsy showing a seizure. The waves are black on a white background.
| caption = Generalized 3&nbsp;[[Hz]] [[spike-and-wave]] discharges on an [[electroencephalogram]]
| field = [[Neurology]]
| symptoms = Periods of loss of consciousness, abnormal shaking, staring, change in vision, mood changes and/or other cognitive disturbances <ref name=WHO2016/>
| complications = 
| onset = 
| duration = Long term<ref name=WHO2016/>
| causes = Unknown, [[brain injury]], [[stroke]], [[brain tumor]]s, infections of the brain, [[birth defects]]<ref name=WHO2016/><ref name=Ham2010/><ref name=Gol2013/>
| risks = 
| diagnosis = Electroencephalogram, ruling out other possible causes<ref name=Longo2012/>
| differential = [[Syncope (medicine)|Fainting]], [[alcohol withdrawal]], [[electrolyte problems]]<ref name=Longo2012/>
| prevention = 
| treatment = Medication, [[Epilepsy surgery|surgery]], [[neurostimulation]], dietary changes<ref name=Bergey2013/><ref name=Mar2018/>
| medication = 
| prognosis = Controllable in 69%<ref name=Ead2012/>
| frequency = 51.7 million/0.68% (2021)<ref name=GBD2021/>
| deaths = 140,000 (2021)<ref name=GBD2021De/>
}}

'''Epilepsy''' is a group of [[Non-communicable disease|non-communicable]] [[Neurological disorder|neurological disorders]] characterized by a tendency for recurrent, unprovoked [[Seizure|seizures]].<ref name=Fisher2014>{{cite journal | vauthors = Fisher RS, Acevedo C, Arzimanoglou A, Bogacz A, Cross JH, Elger CE, Engel J, Forsgren L, French JA, Glynn M, Hesdorffer DC, Lee BI, Mathern GW, Moshé SL, Perucca E, Scheffer IE, Tomson T, Watanabe M, Wiebe S | title = ILAE official report: a practical clinical definition of epilepsy | journal = Epilepsia | volume = 55 | issue = 4 | pages = 475–482 | date = April 2014 | pmid = 24730690 | doi = 10.1111/epi.12550 | doi-access = free }}</ref> 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.<ref name="WHO2016">{{cite web |date=February 2016 |title=Epilepsy Fact sheet |url=https://www.who.int/mediacentre/factsheets/fs999/en/ |url-status=live |archive-url=https://web.archive.org/web/20160311001129/http://www.who.int/mediacentre/factsheets/fs999/en/ |archive-date=11 March 2016 |access-date=4 March 2016 |website=WHO}}</ref> 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.<ref name="WHO2023">{{cite web |title=Epilepsy |url=https://www.who.int/en/news-room/fact-sheets/detail/epilepsy |access-date=1 April 2023 |website=World Health Organization |language=en}}</ref> In some cases, however, it may be diagnosed after a single unprovoked seizure if clinical evidence suggests a high risk of recurrence.<ref name="Fisher2014" /> Isolated seizures that occur without recurrence risk or are provoked by identifiable causes are not considered indicative of epilepsy.<ref name="pmid15816939">{{cite journal |vauthors=Fisher RS, van Emde Boas W, Blume W, Elger C, Genton P, Lee P, Engel J |date=April 2005 |title=Epileptic seizures and epilepsy: definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE) |journal=Epilepsia |volume=46 |issue=4 |pages=470–472 |doi=10.1111/j.0013-9580.2005.66104.x |pmid=15816939 |doi-access=free}}</ref>

The underlying cause is often unknown,<ref name="WHO2023" /> but epilepsy can result from [[brain injury]], [[stroke]], infections, [[Brain tumor|tumors]], genetic conditions, or developmental abnormalities.<ref name="Pand2011">{{cite journal |vauthors=Pandolfo M |date=November 2011 |title=Genetics of epilepsy |journal=Seminars in Neurology |volume=31 |issue=5 |pages=506–518 |doi=10.1055/s-0031-1299789 |pmid=22266888}}</ref><ref name="Ham2010">{{cite book |title=Pathophysiology of disease: an introduction to clinical medicine |publisher=McGraw-Hill Medical |year=2010 |isbn=978-0-07-162167-0 |veditors=Hammer GD, McPhee SJ |edition=6th |location=New York |chapter=7}}</ref><ref name="Gol2013">{{cite journal |vauthors=Goldberg EM, Coulter DA |date=May 2013 |title=Mechanisms of epileptogenesis: a convergence on neural circuit dysfunction |journal=Nature Reviews. Neuroscience |volume=14 |issue=5 |pages=337–349 |doi=10.1038/nrn3482 |pmc=3982383 |pmid=23595016}}</ref> Epilepsy that occurs as a result of other issues may be preventable.<ref name="WHO2016" /> Diagnosis involves ruling out other conditions that can resemble seizures, and may include [[neuroimaging]], blood tests, and [[electroencephalography]] (EEG).<ref name="Longo2012">{{cite book |title=Harrison's principles of internal medicine |vauthors=Longo DL |publisher=McGraw-Hill |year=2012 |isbn=978-0-07-174887-2 |edition=18th |page=3258 |chapter=369 Seizures and Epilepsy}}</ref>

Most cases of epilepsy — approximately 69% — can be effectively controlled with anti-seizure medications,<ref name="Ead2012">{{cite journal |vauthors=Eadie MJ |date=December 2012 |title=Shortcomings in the current treatment of epilepsy |journal=Expert Review of Neurotherapeutics |volume=12 |issue=12 |pages=1419–1427 |doi=10.1586/ern.12.129 |pmid=23237349}}</ref> and inexpensive treatment options are widely available. For those whose seizures do not respond to drugs, other approaches such as [[Epilepsy surgery|surgery]], [[neurostimulation]] or [[Ketogenic diet|dietary changes]] may be considered.<ref name="Bergey2013">{{cite journal |vauthors=Bergey GK |date=June 2013 |title=Neurostimulation in the treatment of epilepsy |journal=Experimental Neurology |volume=244 |pages=87–95 |doi=10.1016/j.expneurol.2013.04.004 |pmid=23583414}}</ref><ref name="Mar2018">{{cite journal |vauthors=Martin-McGill KJ, Bresnahan R, Levy RG, Cooper PN |date=June 2020 |title=Ketogenic diets for drug-resistant epilepsy |journal=The Cochrane Database of Systematic Reviews |volume=2020 |issue=6 |pages=CD001903 |doi=10.1002/14651858.CD001903.pub5 |pmc=7387249 |pmid=32588435}}</ref> Not all cases of epilepsy are lifelong, and many people improve to the point that treatment is no longer needed.<ref name="WHO2016" />

{{as of|2021}}, approximately 51 million people worldwide have epilepsy, with nearly 80% of cases occurring in low- and middle-income countries.<ref name="WHO2016" /> 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.<ref name="Poor2012">{{cite journal |vauthors=Newton CR, Garcia HH |date=September 2012 |title=Epilepsy in poor regions of the world |url=http://elartu.tntu.edu.ua/handle/lib/29589 |journal=Lancet |volume=380 |issue=9848 |pages=1193–1201 |doi=10.1016/S0140-6736(12)61381-6 |pmid=23021288}}</ref> In 2021, epilepsy was responsible for an estimated 140,000 deaths, an increase from 125,000 in 1990.<ref name=GBD2021De>{{cite journal | vauthors=Sinmetz JD, Seeher KM, Schiess N, Nichols E, Cao B, Servili C, et al | journal=The Lancet Neurology | title=Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021 | volume=23 | issue=4 | pages=344–381 | publisher=Elsevier | date=1 April 2024 | doi=10.1016/S1474-4422(24)00038-3| pmid=38493795 | pmc=10949203 | hdl=1959.4/102176 | hdl-access=free }}
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Epilepsy is more common in both children and older adults.<ref name="pmid19800848">{{cite journal |vauthors=Brodie MJ, Elder AT, Kwan P |date=November 2009 |title=Epilepsy in later life |journal=The Lancet. Neurology |volume=8 |issue=11 |pages=1019–1030 |doi=10.1016/S1474-4422(09)70240-6 |pmid=19800848}}</ref><ref name="Holmes2008">{{cite book| vauthors = Holmes TR, Browne GL |title=Handbook of epilepsy|year=2008 |publisher=Lippincott Williams & Wilkins |location=Philadelphia |isbn=978-0-7817-7397-3 |edition=4th |page=7 |url=https://books.google.com/books?id=gLOv8XZ5u48C&pg=PA7 }}</ref> About 5–10% of people will have an unprovoked seizure by the age of 80.<ref name="AFP2012">{{cite journal | vauthors = Wilden JA, Cohen-Gadol AA | title = Evaluation of first nonfebrile seizures | journal = American Family Physician | volume = 86 | issue = 4 | pages = 334–340 | date = August 2012 | pmid = 22963022 }}</ref> The chance of experiencing a second seizure within two years after the first is around 40%.<ref>{{cite journal | vauthors = Neligan A, Adan G, Nevitt SJ, Pullen A, Sander JW, Bonnett L, Marson AG | title = Prognosis of adults and children following a first unprovoked seizure | journal = The Cochrane Database of Systematic Reviews | volume = 1 | issue = 1 | pages = CD013847 | date = January 2023 | pmid = 36688481 | pmc = 9869434 | doi = 10.1002/14651858.CD013847.pub2 | collaboration = Cochrane Epilepsy Group }}</ref><ref>{{cite report |title=Epilepsy: what are the chances of having a second seizure? |date=16 August 2023 |doi=10.3310/nihrevidence_59456 }}</ref> 

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.<ref name="WHO2023" /><ref name="WHO2012">{{cite web |date=October 2012 |title=Epilepsy |url=https://www.who.int/mediacentre/factsheets/fs999/en/ |access-date=24 January 2013 |series=Fact Sheets |publisher=[[World Health Organization]]}}</ref> In many countries, people with epilepsy face driving restrictions and must be seizure-free for a set period before regaining eligibility to drive.<ref name="Drive2012">{{cite journal | vauthors = L Devlin A, Odell M, L Charlton J, Koppel S | title = Epilepsy and driving: current status of research | journal = Epilepsy Research | volume = 102 | issue = 3 | pages = 135–152 | date = December 2012 | pmid = 22981339 | doi = 10.1016/j.eplepsyres.2012.08.003 }}</ref> The word ''epilepsy'' is from [[Ancient Greek]] {{Lang|grc|ἐπιλαμβάνειν}}, 'to seize, possess, or afflict'.<ref name="magiorkinis_2010">{{cite journal | vauthors = Magiorkinis E, Sidiropoulou K, Diamantis A | title = Hallmarks in the history of epilepsy: epilepsy in antiquity | journal = Epilepsy & Behavior | volume = 17 | issue = 1 | pages = 103–108 | date = January 2010 | pmid = 19963440 | doi = 10.1016/j.yebeh.2009.10.023 }}</ref>
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