FREE subscriptions for doctors and students... click here
You have 3 more open access pages.
Epilepsy is not a single condition but a large group of highly heterogeneous disorders, which in common has an abnormally increased predisposition to seizures (1).
- it is defined as a neurological condition characterised by recurrent epileptic seizures unprovoked by any immediately identifiable cause (2)
- the International League Against Epilepsy (ILAE) defines epilepsy as a “a disorder of the brain characterised by an enduring predisposition to generate epileptic seizures and by the neurobiological, cognitive, psychological and social consequences of this condition”. The definition of epilepsy requires the occurrence of at least one epileptic seizure (1).
Epilepsy should be considered as a symptom caused by an underlying neurological disorder and not as a single disease entity (2).
It is a diagnosis which sadly and unnecessarily carries physical, psychosocial
and economic implications for the patient. As such, it ought to not be applied
without thorough consideration.
- epilepsy has been estimated to affect between 362,000 and 415,000 people
in England (3)
- also, there will be further individuals, estimated to be 5-30%, so amounting
to up to another 124,500 people, who have been diagnosed with epilepsy,
but in whom the diagnosis is incorrect
- incidence is estimated to be 50 per 100,000 per year and the prevalence
of active epilepsy in the UK is estimated to be 5-10 cases per 1000
- two-thirds of people with active epilepsy have their epilepsy controlled
satisfactorily with anti-epileptic drugs (AEDs) (3)
- other approaches may include surgery. Optimal management improves health
outcomes and can also help to minimise other, often detrimental, impacts
on social, educational and employment activity
- a large multicentre trial (the SANAD trial) evaluating newer drugs in newly
diagnosed epilepsy (accepting some limitations) suggested that sodium valproate
should be the drug of choice in generalised and unclassifiable epilepsies,
and lamotrigine in focal epilepsies (3)
Note that there is confusion between the terms epilepsy and seizure, and they
are often used interchangeably. The confusion is not helped by the term status
epilepticus, which need not have anything to do with epilepsy. The two are separated
Last edited 08/2018 and last reviewed 01/2021