Epilepsy

For a lay person:

Epilepsy is a brain condition where a person has a tendency to experience repeated seizures. A seizure is like a sudden "electrical storm" in the brain that temporarily disrupts normal brain function. This can cause different things depending on the part of the brain involved — from staring blankly and not responding for a few seconds, to falling down, shaking all over, or making unusual movements. It’s not contagious, and many people with epilepsy live full, active lives with proper treatment (often medication). It’s one of the most common neurological disorders.

For a trained medical person:

Epilepsy is a chronic neurological disorder characterized by a persistent predisposition to generate unprovoked epileptic seizures, with neurobiological, cognitive, psychological, and social consequences. According to the International League Against Epilepsy (ILAE), it is defined by any of the following:

• At least two unprovoked seizures occurring >24 hours apart.
• One unprovoked seizure with a ≥60% probability of further seizures occurring over the next 10 years (comparable to the general recurrence risk after two unprovoked seizures).
• Diagnosis of an epilepsy syndrome.

Seizures result from excessive, hypersynchronous neuronal activity in the brain. Classification includes focal (originating in one hemisphere), generalized (involving both hemispheres from onset), and unknown onset. Etiologies are categorized as structural, genetic, infectious, metabolic, immune, or unknown. Diagnosis relies on clinical history, electroencephalography (EEG), and neuroimaging (MRI preferred). Management typically involves antiseizure medications (ASMs), with potential for epilepsy surgery, neuromodulation (e.g., VNS, RNS), or dietary therapy in drug-resistant cases. Status epilepticus is a medical emergency. Long-term considerations include sudden unexpected death in epilepsy (SUDEP), comorbidities (e.g., depression, cognitive impairment), and driving/safety counseling.