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The mystery of epilepsy: Why does electrical activity in the brain go haywire?
Epilepsy is a group of non-communicable neurological disorders characterised by recurrent seizures. Epileptic seizures are clinical manifestations of abnormal, excessive, and synchronized electrical activity in neurons. According to the definition of the International Epilepsy League, the criterion for epilepsy is the occurrence of two or more epileptic seizures without obvious triggers. Seizures can range from brief, barely noticeable episodes to prolonged, intense convulsions caused by abnormal electrical activity in the brain. These episodes can result in physical injuries, such as broken bones, or cause harm by causing an accident.
Seizures in people with epilepsy are often erratic and may lack a detectable underlying cause.
The cause of epilepsy is still not fully understood; in many patients epilepsy is classified as cryptogenic, while in others it may be caused by brain injury, stroke, brain tumors or birth defects. Known genetic mutations have been directly linked to a small number of cases. When diagnosing epilepsy, doctors rule out other conditions that may cause similar symptoms, such as fainting or electrolyte abnormalities. This usually requires brain imaging and blood tests. Electrophysiological testing (EEG) is often used to confirm epilepsy, but normal results do not rule out the possibility of epilepsy.
Epilepsy can be controlled with medication in approximately 69% of cases, and economical anti-epileptic drugs are often available.
Epilepsy affects approximately 51 million people, 80% of whom live in developing countries. The latest data shows that the number of deaths caused by epilepsy reached 140,000 in 2021, an increase from 125,000 in 1990. Epilepsy is more common in children and the elderly. In developing countries, epileptic seizures usually occur in young children and young adults, while in developed countries new cases are more common in infants and the elderly. .
Symptoms and effects of epilepsy
Epilepsy is characterized by long-term recurring seizures. Seizures can look different depending on which part of the brain is affected and the age of the person. The most common type of seizure is convulsion, accounting for about 60 percent of cases. These seizures involve involuntary muscle contractions. Depending on the situation, epileptic seizures can be divided into partial seizures and generalized seizures, the latter of which affect both cerebral hemispheres and cause loss of consciousness.
Epileptic seizures may be accompanied by mental and sensory experiences and may manifest differently depending on the area of the brain that is damaged.
In children and adolescents, the effects of epilepsy are not limited to physical aspects but may also have negative consequences on social and mental health. These include social isolation, stigma, and disability, which can lead to low educational achievement and poor employment outcomes. Many people with epilepsy may also face learning difficulties, especially children. However, many people with epilepsy are able to manage their symptoms with appropriate treatment.
Causes of epilepsy
The causes of epilepsy can be divided into hereditary and acquired. Genetic factors play a role in most cases of epilepsy. Many cases have been associated with changes in ion channels in neurons, which may increase neuronal excitability and trigger seizures.
Studies have shown that for individuals whose siblings have a history of epilepsy, the risk of developing the disease is significantly increased.
The risk of epilepsy is statistically increased in patients with brain injury, human trauma, and brain tumors. Epilepsy may also be related to certain infections and brain disorders. It is important to note that chronic alcohol abuse, Alzheimer's disease, and multiple sclerosis can also increase the risk of epilepsy.
Mechanisms and triggering factors
The exact mechanism of epilepsy is still not fully understood, but it is known to be related to abnormal electrical activity of neurons. Normally, the electrical activity of neurons is not synchronized, but during an epileptic seizure, neurons fire abnormally quickly and synchronously, which can cause a seizure to occur.
Epileptic seizures are often triggered by specific factors, including stress, excessive drinking or lack of sleep. In these cases, people with epilepsy have a lowered seizure threshold, meaning that less stimulation than normal is needed to trigger a seizure.
How do you view the life and treatment of epilepsy patients, especially when the magic cure has not yet been discovered?
People with epilepsy often face many challenges in their daily lives, including social stigma and psychological distress. Faced with such a complex and elusive disease, we have reason to explore and study further, perhaps to find ways to improve treatment and social acceptance. Perhaps one day in the future, epilepsy will no longer be just a mysterious term, but can be deeply understood. How can we help in this journey of understanding and treating diseases?
