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Epilepsy

Definition and Frequency

Epileptic attacks develop due to a sudden overexcitation of millions of nerve cells. Epilepsy is the most common chronic disease of the central nervous system. Around 5% of the population suffer once in their lives from an epileptic attack. Active epilepsy, attacks that occur without a trigger, is found in only 0.8% of the European population (ca. 600,00 in Germany). The risk of an epileptic attack is especially high in the first year of life and then again starting from around age 60.

Classification, Development, Causes

There are 2 main types of epilepsy

  • Focal:

    • here the source of the seizure is localized; 

  • Generalized:

    • the source of the seizure distributed throughout the brain

Both types can be further subdivided into further categories which are determined by the source of the seizure, age of patient when the disease first appeared, as well as type of seizure. Each type of epilepsy can have typical types of seizures associated with it, but this is not always the case. A syndrome diagnosis is important for the prognosis and the treatment. Often during an epileptic attack, clinical signs occur which are important for determining which area of the brain the seizure originated in. Epilepsy is either a sign of a brain disease or they develop through genetically inherited changes in the cellular level. Triggers for those prone to epileptic attacks include sleep or alcohol detoxification. Causes include cerebral hemorrhaging, injury, or lack of oxygen in the brain. 

Therapy

Epilepsy treatment is usually medicinal (antiepileptic) which prevent overexcitement in the brain. Using this method, 60-70% of all patients experience success using medication. Usually only one medication is needed, although sometimes two or even three must be taken parallel to each other. The dosis is dependent upon the effect and side effects of the medication, which should work without problem as long as they are taken properly. Also very important is keeping track of the attacks and times of medication intake.

For 20-30% of patients, for whom medication does not work, the following alternatives are recommended:

  • surgical option
  • study medication
  • Vagus nerve stimulation

Further Literature

Epilepsien. Fragen und Antworten.
von Dieter Schmidt; Preis: ca. EUR 14,90; Zuckschwerdt Verlag, Erscheinungsdatum: November 2001, ISBN: 3886037673 (German)

http://www.epilepsie.sh/Weitergehende_Literatur.31.0.html (German)

Epilepsy from the German Neurological Society (http://www.dgn.org/11.0.html). (German)