Summary: Epilepsy is another name for recurrent unprovoked seizures. By unprovoked, neurologists mean there is no identifiable cause of the seizure such as a very low blood sugar, a stroke, meningitis, or alcohol withdrawal. Seizures occur because of the excessive discharge of the neurons in the brain. People then have self-limited abnormalities that can be observed by others such as staring into space or movement disorders. Epilepsy itself is more likely to occur in young children or people over the age of 65 years. Not all epilepsy syndromes are life long, and frequently epilepsy is controllable but not curable with medicines. For the 30% or so of people with epilepsy who do not have good seizure control even with the best available medications, surgery may be beneficial. The goal is control of the seizures with medicines or other techniques that produce minimal or no side effects. When people have recurrent unprovoked seizures, they have epilepsy. It is not a single disease but very different symptoms can occur because of the common pathway of abnormal electrical activity in the brain. Seizures can be partial or they can be global and they can involve motor activity abnormalities such as flailing of arms and legs, or they can involve periods of time where the person with the seizure just appears to have “spaced out”. For the 50 million people worldwide with epilepsy the vast majority are either young children or people over the age of 65 years. Not all epilepsy syndromes are lifelong. Epilepsy is usually controlled but not cured with medication but for the 30% of people with epilepsy who do not respond to seizure control medications, more aggressive treatments such as surgical intervention may be beneficial. This type of evaluation is best performed by neurologist and/or neurosurgeons who concentrate on taking care of people with refractory epilepsy.
