Epilepsy general
- Epilepsy is a chronic disorder of the brain that affects people of all ages.
- More than 50 million people worldwide have epilepsy and 80% of them live in developing countries.
- Approximately 3% to 3.5% of Australians will experience epilepsy at some point in their lives and over 250,000 Australians are currently living with epilepsy.
Diagnosis and prognosis
- Seizures can begin at any age, but epilepsy is most frequently diagnosed in early childhood, adolescence and people over 65 years of age.
- Children represent approximately 40% of the population with epilepsy, adults 30% and the elderly 25–30%.
- At least 15% of people referred to an epilepsy specialist centre do not actually have epilepsy and have been previously misdiagnosed.
- Epilepsy is diagnosed if someone has:
- At least two unprovoked (or reflex) seizures
- One unprovoked (or reflex) seizure and a probability of further seizures happening
- Diagnosis of an epilepsy syndrome
- Many people outgrow or have a long term remission from seizures. Epilepsy is not necessarily a lifelong disorder.
- Epilepsy is considered “resolved” in someone who
- has an age-dependent epilepsy syndrome but are older than the applicable age
- is seizure-free for 10 years, with no seizure medication for the last 5 years
- Epilepsy is linked with an increased risk of death, up to 2-3 times the general populationi which may be related to:
- An underlying brain disease, such as a tumour or infection
- Accidents or seizures in dangerous circumstances leading to drowning, burns or head injury
- Seizure emergencies – prolonged or ongoing seizures
- Sudden and unexplained causes – SUDEP
- Stopping breathing during a seizure
- Treatment related death
- Suicide.
Types of seizures
- It is commonly thought that epilepsy always involves convulsions. In fact there are around 40 different types of epilepsy and epilepsy syndromes, many are not convulsive
- Seizures can vary from the briefest lapses of attention, confusion or unusual behaviours to severe and prolonged convulsions
- Seizures can also vary in frequency, from less than 1 per year to several per day
Treatment
- With treatment, about 60-70% of people with epilepsy can be seizure free, yet about three quarters of people in developing countries do not get the treatment they need
- After 2 to 5 years of successful treatment and being seizure-free, medications can be withdrawn in about 70% of children and 60% of adults without later relapse.
- A small percentage of people may be suitable for epilepsy surgery. Over half the number of people who have surgery become seizure free long term.vii Many others have fewer or less severe seizures after surgery
- Other treatment options for people who cannot get seizure control with medications include Vagus Nerve Stimulation and the Ketogenic Diet.
Lifestyle/other
- Epilepsy can have significant social, physical and psychological consequences.
- People with epilepsy can face social stigma and exclusion. A fundamental part of reducing this stigma is to raise public and professional awareness.
- People with epilepsy can obtain a driver’s licence if their seizures are controlled by medication or if they fulfil the guidelines set out by the driving authorities.
- Epilepsy is a condition of the brain, not a mental illness.
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