What is Epilepsy?

Epilepsy is not a single disorder, but covers a wide spectrum of problems characterized by unprovoked, recurring seizures that disrupt normal neurologic functions. Epileptic seizures occur when a group of nerve cells in the brain (neurons) become activated simultaneously, emitting sudden and excessive bursts of electrical energy. This hyperactivity of neurons can occur in various locations in the brain and, depending on the location, have a wide range of effects on the sufferer from brief moments of confusion to minor spasms to loss of consciousness.

The nerves themselves may be damaged or problems might occur in neurotransmitters (die chemicals that act as messengers between nerve cells). The neurotransmitter, gamma aminobutyric acid (GABA) seems to be particularly important in suppressing seizures. Experiments also suggest that deficiencies in a receptor of the neurotransmitter serotonin may help promote epileptic seizures.

Epilepsy falls into two main categories: partial, or focal, seizures and generalized seizures. Within these two categories are a number of subtypes, each of which requires different therapeutic approaches, so an accurate diagnosis is important. In addition, some cases of epilepsy can be a hybrid of subtypes, while others defy precise categorization.

What is the Cause of Epilepsy?
It is estimated that 50 million people worldwide and 2.5 million Americans have epilepsy. About 75% of epileptic seizures start in childhood. About 5% of the population will have at least one seizure, not counting the 5% of children who have seizures caused by fevers. The cause can be determined for about 28% of partial epilepsy patients, but in nearly three quarters of all cases, the cause is unknown. The age of onset can sometimes offer a clue.

Possible causes for epilepsy including

Infections
Head injuries
Brain tumors
Brain injuries at birth
Inherited disease.

Diagnosis of Epilepsy
Epilepsy is essentially a clinical diagnosis i.e. from history and physical examination. Detailed account of the attack from patient and the eyewitness is more important than the results of all the investigations as regards confirmation of the diagnosis. It often gives clues to the basic cause as well. Thus every effort must be made to obtain this.

Investigations are done to confirm the diagnosis and determine the cause. Depending on the age of the onset of the first seizures and associated symptoms and signs, the doctor decides the number and priority of the investigations. They include:

Plain X–rays of skull and chest.
Blood count and haemoglobin concentration.
Electroencephalogram (EEG).
Cerebrospinal Fluid Examination obtained through lumbar puncture.
CT Scans and MRI Scans of the brain.
Angiography.
IQ test and personality tests.