What is epilepsy?

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By Ameena Drammeh

Ameena making a class presentation for a "A Day in Islamic History"

Assalamulakum. My name is Ameena Drammeh. My subject is medicine and health, and the topic I will be discussing is epilepsy. The reason I chose this topic is because I have a little sister that has been and living with epilepsy for the past 10 years.

Epilepsy is a common chronological neurological disorder characterized by seizures. These seizures are transient signs and/or symptoms of abnormal, excessive or hypersynchronous neuronal activity in the brain. About 50 million people worldwide have epilepsy, and nearly two out of every three cases are discovered in developing countries. Epilepsy is more likely to occur in young children, or people over the age of 65; however it can occur at any time. As a consequence of brain surgery, epileptic seizures may occur in recovering patients.

Epilepsy is usually controlled, but not cured with medication. However 30% of people with epilepsy do not have seizure control even with the best available medications. Surgery may be considered in difficult cases. Not all epilepsy syndromes are lifelong- some forms are confined to particular stages in childhood. Epilepsy should not be understood as a single disorder, but rather as syndromic with vastly divergent symptoms but all involving episodic electrical activity in the brain.

The cause of epilepsy usually requires that the seizures occur spontaneously. Nevertheless, certain epilepsy syndromes require particular participants or triggers for seizures to occur. These are classified as reflex epilepsy. For example people with primary reading epilepsy have seizures triggered by reading. Photosensitive epilepsy can be limited to seizures triggered by flashlights. Other participants can trigger an epileptic seizure in patients who otherwise would be susceptible to spontaneous seizures. For example children with childhood absence epilepsy may be susceptible with hyperventilation.

Mutations in several genes have been linked to several types of genes. Several genes that code for protein sub-units of voltage-gated and ligand-gated ion channels have been associated with forms of generalized epilepsy and infantile seizure syndromes. Several ligated-gated ion channels have been linked to some types of frontal and generalized epilepsies.

The mainstay of treatment of epilepsy is anticonvulsant medications. Often, anticonvulsant medication treatment will be life-long and can have major effects on equality of life. The choice among anticonvulsant and their effectiveness differs by epilepsy syndromes. Mechanisms, effectiveness for particular epilepsy syndromes and side- effects differ among the individual anticonvulsant medications.

Epilepsy surgery is an option for patients whose seizures remain resistant to treatment with anticonvulsant medications who also have symptomatic localization-related epilepsy; a focal abnormality that can be located and therefore removed. The goal for these procedures is total control of epileptic seizures, although anticonvulsant medications may still be required.

Many notable people, past and present have carried the diagnosis of epilepsy. In many cases, their epilepsy is a footnote of their accomplishments; for some, it played an integral role in their fame. Historical diagnosis of epilepsy is not always certain; there is controversy about what is considered an acceptable amount of evidence in support of such a diagnosis.

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