Epilepsy

Epilepsy is a chronic neurological condition characterized by recurrent unprovoked seizures. The condition is named from the Greek epilepsia ("a taking hold of or seizing"), and has in the past been associated with religious experiences and even demonic possession. Many neurologists prefer the less stigmatized term "seizure disorder" as a description of the condition.

Causes
The terms epilepsy and seizure disorder refer only to a set of symptoms, not to a particular disease or cause. Epileptic seizures are the result of an abnormal discharge of neurons in the brain, and can range from the generalized tonic/clonic (Grand Mal) seizure to more limited partial forms. Generalized seizures include the aforementioned Tonic/Clonic seizures, Absence (Petit Mal) seizures, which are characterized by a brief loss of awareness, and Atonic seizures (Drop Attacks). They are called Generalized Seizures because the associated abnormal electrical discharge takes place over the entire brain at the outset.

Partial seizures begin in a limited area of the brain and either stay there (Simple Partual Seizure), or spread (Complex Partial Seizure). Complex Partial Seizures can spread further to the entire brain (Secondary Generalization).

Seizures can result from a number of unrelated conditions, including residual scarring from stroke, toxicity, electrolyte imbalances, brain diseases and head trauma. Generalized tonic/clonic seizures may occur in any person under certain circumstances, including fevers and drug overdoses, but these patients are not typically classified as epileptics. Epilepsy connotes that an individual has seizures which recur over time in an unpredictable fashion. In 70% of all cases, there is no definable cause for epilepsy. It can occur in anyone at any age with no apparent etiological basis. In the other 30% of cases, an injury or disease of the brain is present, and the abnormal electrical activity can be traced to this region.

The most common ages of onset for epilepsy are for those under the age of 18 and those over the age of 65. About 4% of the population has some form of epilepsy. Epilepsy does not cause mental retardation or brain deterioration, except in cases where brain damage results from Status Epilepticus (see below).

Categories
Epileptic seizures can generally be classified into a number of categories: "Simple", "Complex" and "Secondarily generalized" are members of the "Partial" family. "Absence", "Clonic", "Myoclonic", "Tonic" and "Tonic-Clonic" are members of the "General" family. There are also various unclassified types of seizure.

Treatment
Epilepsy is often treated with medication, Neurocybernetic Prostheses (similar to a heart pacemaker) and occasionally via surgery or specialized diet. In most cases, the proper emergency response to a Generalized Tonic/Clonic epileptic seizure is simply to prevent the patient from injuring themselves, by moving him or her away from sharp edges, placing something soft beneath the head, and carefully moving them onto their side to avoid asphyxiation. If the seizure lasts longer than 3-4 minutes, contact Emergency Medical Services immediately, as this may indicate the presence of Status Epilepticus, a potentially fatal condition. One should never place any object in a person's mouth during a seizure as this could result in injury to the victim's mouth. It is not possible (despite folklore to the contrary) for a person to swallow the tongue during a seizure.

Various drugs have been discovered that serve to control or limit seizures, including carbamazepine (brand name Tegretol), oxcarbazepine (Trileptal), clonazepam (Klonopin), ethosuximide (Zarontin), felbamate (Felbatol), fosphenytoin (Cerebyx), gabapentin (Neurontin), lamotrigine (Lamictal), phenobarbital (Luminal), phenytoin (Dilantin), primidone (Mysoline), tiagabine (Gabitril), topiramate (Topamax), valproate, sodium divalproex (Depakene, Depakote) and vigabatrin (Sabril).

Ketogenic diets have also been found to be effective in controlling some types of epilepsy, although the mechanism behind the effect is not fully understood. Ketogenic diets are high in fat and extremely low in carbohydrates, with intake of fluids often limited. This treatment, originated as early as the 1920s, was largely abandoned with the discovery of modern anti-epileptic drugs, but has enjoyed a return to popularity in recent times. Ketogenic diets are sometimes prescribed in severe cases where drugs have proven ineffective.

Controversy
There has been some controversy – although very little – over the standards for diagnosis for partial-complex seizures and how these standards are applied in practice, both among some surrealists and in particular as regards Mary Baker Eddy, founder of Christian Science.

In April 2003, the BBC TV science programme "Horizon" featured discussion of research by American neurologist Gregory Holmes indicating that Ellen G. White, spiritual founder of the Seventh-day Adventist Church, may have suffered from temporal lobe epilepsy triggered by a head injury at age nine – the epilepsy supposedly being responsible for her powerful religious visions.

There has also been serious speculation that science fiction author Philip K. Dick suffered from similar seizures; he experienced visions on several occations, that, among other effects, reportedly helped him save his infant son from an undiagnosed life-threatening medical condition.

Famous known sufferers of epilepsy

• Ian Curtis of Joy Division
• Julius Caesar
• Napoleon Bonaparte
• Alexander the Great
• Mohammed
• George Gordon Byron, 6th Baron Byron
• Fyodor Dostoevsky
• Vincent van Gogh
• Danny Glover

Epilepsy, depression and suicide
It is interesting to note that both Ian Curtis and Vincent van Gogh suffered depressions – possibly linked to the difficulties seizures caused them – and both ended up committing suicide. For more information on suicide and other Epilepsy-related death, research Sudden Unexplained Death in Epilepsy (SUDEP).

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