Epilepsy (from the Ancient Greek verb meaning "to seize, possess, or afflict")[1] is

a group of neurological disorders characterized by epileptic seizures.[2][3] Epileptic seizures are

episodes that can vary from brief and nearly undetectable to long periods of vigorous shaking.[4]
In epilepsy, seizures tend to recur, and have no immediate underlying cause[2] while seizures that
occur due to a specific cause are not deemed to represent epilepsy.[5]
The cause of most cases of epilepsy is unknown, although some people develop epilepsy as the
result of brain injury, stroke, brain tumor, and drug and alcohol misuse. Genetic mutations are
linked to a small proportion of the disease.[6] Epileptic seizures are the result of excessive and
abnormal cortical nerve cell activity in the brain.[5] The diagnosis typically involves ruling out
other conditions that might cause similar symptoms such as fainting. Additionally, making the
diagnosis involves determining if any other cause of seizures is present such as alcohol
withdrawal or electrolyte problems.[6] This may be done by imaging the brain and performing
blood tests.[6] Epilepsy can often be confirmed with an electroencephalogram (EEG) but a normal
test does not rule out the condition.[6]
Seizures are controllable with medication in about 70% of cases.[7] In those whose seizures do
not respond to medication, surgery, neurostimulation or dietary changes may be considered. Not
all cases of epilepsy are lifelong, and many people improve to the point that medication is no
longer needed.
About 1% of people worldwide (65 million) have epilepsy,[8] and nearly 80% of cases occur in
developing countries.[4] In 2013 it resulted in 116,000 deaths up from 111,000 deaths in 1990.[9]
Epilepsy becomes more common as people age.[10][11] In the developed world, onset of new cases
occurs most frequently in infants and the elderly;[12] in the developing world this is in older
children and young adults,[13] due to differences in the frequency of the underlying causes. About
510% of all people will have an unprovoked seizure by the age of 80,[14] and the chance of
experiencing a second seizure is between 40 and 50%.[15] In many areas of the world those with
epilepsy either have restrictions placed on their ability to drive or are not permitted to drive,[16]
but most are able to return to driving after a period of time without seizures.

Contents

1 Signs and symptoms

o 1.1 Seizures
o

1.2 Postictal

1.3 Psychosocial

2 Causes
o

2.1 Genetics

2.2 Acquired

3 Pathophysiology

3.1 Epilepsy

3.2 Seizures

4 Diagnosis
o

4.1 Definition

4.2 Classification

4.3 Syndromes

4.4 Tests

4.5 Differential diagnosis

5 Prevention

6 Management

6.1 First aid

6.2 Medications

6.3 Surgery

6.4 Other

6.5 Alternative medicine

7 Prognosis
o

7.1 Mortality

8 Epidemiology

9 History

10 Society and culture

o

10.1 Stigma

10.2 Economics

10.3 Vehicles

10.4 Support organizations

11 Research

12 Other animals

13 References

14 Further reading

15 External links

Signs and symptoms

Play media
An instructional video about epileptic seizures

A bite to the tip of the tongue due to a seizure

Epilepsy is characterized by a long-term risk of recurrent seizures.[17] These seizures may present
in several ways depending on the part of the brain involved and the person's age.[17][18]

Seizures
The most common type (60%) of seizures are convulsive.[18] Of these, one-third begin as
generalized seizures from the start, affecting both hemispheres of the brain.[18] Two-thirds begin
as partial seizures (which affect one hemisphere of the brain) which may then progress to
generalized seizures.[18] The remaining 40% of seizures are non-convulsive. An example of this
type is the absence seizure, which presents as a decreased level of consciousness and usually
lasts about 10 seconds.[19][20]
Partial seizures are often preceded by certain experiences, known as an aura.[21] These may
include sensory (visual, hearing or smell), psychic, autonomic, or motor phenomena.[19] Jerking
activity may start in a specific muscle group and spread to surrounding muscle groups in which
case it is known as a Jacksonian march.[22] Automatisms may occur; these are non-consciously
generated activities and mostly simple repetitive movements like smacking of the lips or more
complex activities such as attempts to pick something up.[22]

There are six main types of generalized seizures: tonic-clonic, tonic, clonic, myoclonic, absence,
and atonic seizures.[23] They all involve loss of consciousness and typically happen without
warning.
Tonic-clonic seizures present with a contraction of the limbs followed by their extension along
with arching of the back which lasts 1030 seconds (the tonic phase). A cry may be heard due to
contraction of the chest muscles. This is then followed by a shaking of the limbs in unison
(clonic phase). Tonic seizures produce constant contractions of the muscles. A person often turns
blue as breathing is stopped. In clonic seizures there is shaking of the limbs in unison. After the
shaking has stopped it may take 1030 minutes for the person to return to normal; this period is
called the "postictal state" or "postictal phase". Loss of bowel or bladder control may occur
during a seizure.[4] The tongue may be bitten at either the tip or on the sides during a seizure.[24]
In tonic-clonic seizure, bites to the sides are more common.[24] Tongue bites are also relatively
common in psychogenic non-epileptic seizures.[24]
Myoclonic seizures involve spasms of muscles in either a few areas or all over.[25] Absence
seizures can be subtle with only a slight turn of the head or eye blinking.[19] The person does not
fall over and returns to normal right after it ends.[19] Atonic seizures involve the loss of muscle
activity for greater than one second.[22] This typically occurs on both sides of the body.[22]
About 6% of those with epilepsy have seizures that are often triggered by specific events and are
known as reflex seizures.[26] Those with reflex epilepsy have seizures that are only triggered by
specific stimuli.[27] Common triggers include flashing lights and sudden noises.[26] In certain types
of epilepsy, seizures happen more often during sleep,[28] and in other types they occur almost only
when sleeping.[29]

Postictal
After the active portion of a seizure, there is typically a period of confusion referred to as the
postictal period before a normal level of consciousness returns.[21] This usually lasts 3 to 15
minutes[30] but may last for hours.[31] Other common symptoms include feeling tired, headache,
difficulty speaking, and abnormal behavior.[31] Psychosis after a seizure is relatively common,
occurring in 610% of people.[32] Often people do not remember what happened during this time.
[31]
Localized weakness, known as Todd's paralysis, may also occur after a partial seizure. When
it occurs it typically lasts for seconds to minutes but may rarely last for a day or two.[33]

Psychosocial
Epilepsy can have adverse effects on social and psychological well-being.[18] These effects may
include social isolation, stigmatization, or disability.[18] They may result in lower educational
achievement and worse employment outcomes.[18] Learning difficulties are common in those with
the condition, and especially among children with epilepsy.[18] The stigma of epilepsy can also
affect the families of those with the disease.[4]
Certain disorders occur more often in people with epilepsy, depending partly on the epilepsy
syndrome present. These include depression, anxiety disorders, and migraines.[34] Attention

deficit hyperactivity disorder affects three to five times more children with epilepsy than children
in the general population.[35] ADHD and epilepsy have significant consequences on a child's
behavioral, learning, and social development.[36] Epilepsy is also more common in autistic
people.[37]