Lateral view of brain with neuron inset; SOURCE: Pickup from ANerv_20140205_v0_003 and iConsult ortho_brain_L

What is epilepsy and why they occur?

Characterized by recurrent seizures and seizures that lead to neurobiological, cognitive, and psychological problems, we explain what epilepsy consists of, its causes, how it manifests itself, and how it is treated.

Epilepsy is one of the most important and prevalent chronic neurological diseases worldwide caused by one or more disorders that predispose the brain to generate recurrent seizures, which has neurobiological consequences and cognitive and psychological.

The literature on epilepsy has historically been plagued with errors that have fed its black legend and have motivated epileptic patients to suffer an unjustified stigma in their social and work relationships, which also generates problems for the patient mood anxiety. 

Prevalence of epilepsy

Epilepsy is considered to be the 3rd most common neurological disorder after strokes (cerebrovascular accidents) and dementia and is estimated to affect 0.5-1.5% of the population. According to the World Health Organization, almost 50 million people live with this disease, of which three-quarters do not receive the necessary treatment, and each year around five million new cases of epilepsy are diagnosed in the world.

It is estimated that 225,000 people have suffered epileptic seizures in the last five years. It is estimated that about 578,000 people will suffer from epilepsy throughout their lives, according to estimates of the Spanish Federation of Epilepsy (FEDE) and the Spanish Society of Neurology (SEN).

Most cases occur in children under ten years of age and people over 65. They are more frequent in underdeveloped countries and among disadvantaged socio-economic classes. WHO estimates that in high-income countries, 49 out of 100,000 people are diagnosed with epilepsy each year and that this figure would rise to 139 out of 100,000 people in the case of low- and middle-income countries. 

Approximately 80% of patients with epilepsy live in low- and middle-income countries, which is attributed to their population being at higher risk of endemic diseases such as malaria or neurocysticercosis; that there is a higher incidence of injuries caused by traffic accidents or as a result of childbirth; and less accessibility to medical care and the lack of preventive health programs.

One of the biggest problems with this disease is that it has a complicated diagnosis and can be delayed up to 10 years. One in four crises may go unnoticed by those affected and their families. And it is that epileptic seizures “do not always manifest as a seizure. Although all tend to have a sudden, sudden onset and last for seconds or a few minutes, on many occasions, patients present more subtle seizures in which a disconnection predominates. Partial or total of the environment, and in which the motor phenomena with which we usually associate with this disease – such as shaking, tremors, or more complex movements, such as automatisms – are scarce and are not the prominent phenomenon”, points out Dr. Francisco Javier López Gonzalez, Coordinator of the Epilepsy Group of the Spanish Neurology Society.

Crisis Epileptic, what they are and why they occur

Crisis epileptic is produced by one abnormal discharge and exaggerated by certain groups of neurons in the brain. The abnormal neural downloads trigger crises epileptic should have placed one series of processes: synchronization, amplification, and spread of the downloads.

The download seizure results from an imbalance between excitatory and inhibitory mechanisms to which the neurons are exposed. Epileptogenesis is when one structure is hyperexcitable normal nerve becomes, until eventually generate crises Epileptic spontaneously.

To determine whether it is one Crisis Epileptic there to take into account that :

  • Not all download paroxysmal of the brain, even detectable in the electroencephalogram (EEG), is one Crisis Epileptic if it does not provide clinically.
  • Paroxysmal brain dysfunction that was not produced due to one download hipersíncrona neuronal, but of another kind, is not considered crises epileptic but can cause similar clinical manifestations.
  • The downloads of other groups neural outside the cerebral cortex, such as the brain stem or spinal, give place to paroxysmal events, such as muscle spasms, which are not crises epileptic but respond to the same drugs.
  • In the epilepsy treatment section and in What to do in case of an epileptic seizure, we specify how to act in case of witnessing a seizure in a person with epilepsy.