What is epilepsy?

Epilepsy and epileptic seizures

Epilepsy is one of the most common neurological diseases, affecting about 50 million people of all ages worldwide.¹ In Italy, about 500,000 to 600,000 people have epilepsy.² Its name is derived from the Greek word epilambanein, meaning "to be overwhelmed", "to be taken by surprise".²

The disease is characterized by a persistent predisposition to spontaneous seizures and has consequences that can be:³

• neurological
• cognitive

A seizure is a transient event with signs or symptoms caused by abnormal, excessive or hypersynchronous activity of the neurons in our brain.⁴

There are different types of seizures; the current classification divides them into two broad categories:⁴

• partial, when one area of the cerebral cortex is activated
• generalized, when activation involves the entire cortex
  
  

Epileptic seizures can be subdivided into:⁴

• provoked seizures, also known as acute symptomatic seizures, which may have various causes such as a tumour, an infection, a head injury or vascular abnormalities
• unprovoked seizures, occurring in the absence of a cause or at least seven days after an acute injury or lesion such as a stroke or brain haemorrhage

Or into:

• motor seizures⁵
  • atonic, with loss of muscle tone limited to one muscle group
  • tonic, with sustained muscular stiffening
  • myoclonic, with irregular, short, localized motor "jerks"
  • clonic, with localized, rhythmic muscle contractions
  • hyperkinetic, with complex and stereotyped motor behaviours, e.g., pedalling

• non-motor seizures⁵
  • sensory seizures, such as a sensation of unpleasant smells, visual hallucinations, auditory sensations including buzzing, whistling, but also sounds, voices and melodies
  • autonomic seizures, such as unpleasant gastrointestinal sensations, goose bumps and hot flashes
  • cognitive seizures such as delusions
  • emotional seizures characterized by, for instance, anxiety, agitation, fear, anger, paranoia, joy

The impact of epilepsy on people’s lives

Epilepsy has a particularly significant social impact: many persons with epilepsy have cognitive function deficits, mental health issues and problems with social adjustment resulting in impaired quality of life.⁵

Because seizures are unpredictable and do not remain hidden, epilepsy is a destabilizing condition in all social situations and strongly interferes, for example, with the possibility of finding employment.⁶ Children with epilepsy often have problems with integration and socialization at school, mainly due to misinformation.⁵ It is important to note that epilepsy has a far-reaching impact beyond the individual who is diagnosed with the disease. Family members are also affected, and the economic and employment implications are significant.

Therefore, epilepsy is a cause of:⁵

• disability
• morbidity
• mortality
• stigma
• social costs

Although epilepsy may affect people of both sexes and all ages, three special populations can be distinguished:⁷

• older persons
• women
• children

These three categories are considered "special" because of the physical and metabolic differences they present. They therefore require particular attention during the treatment of the disease.⁷

For example, in women the frequency and severity of seizures may vary during puberty, in the different phases of the menstrual cycle, during pregnancy and in menopause.⁸

In conclusion, epilepsy is a noncontagious neurological disease characterized by recurrent seizures, i.e., brief episodes of involuntary movement that may involve part of the body (partial) or the entire body (generalized) and are sometimes accompanied by loss of consciousness and loss of control of bowel or bladder function.⁹ Epilepsy has a profound impact on the lives of persons affected by it, who are often faced with:⁹

• reduced opportunities in education
• difficulty obtaining a driving licence
• barriers in the realm of employment
• reduced access to health insurance and life insurance