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What is Epilepsy

Epilepsy is a chronic neurological disorder characterized by recurrent unprovoked seizures resulting from abnormal electrical activity of neurons in the brain. Seizures may manifest as convulsions, brief loss of consciousness, sensory or motor disturbances, behavioral changes, or perceptual abnormalities. The condition can develop at any age, has diverse causes, and requires long-term monitoring and individualized treatment. With proper diagnosis and therapy, most patients can achieve sustained seizure control and maintain a high quality of life.

When is Epilepsy Diagnosed

Epilepsy is diagnosed if any of the following criteria are met:

  1. Two or more unprovoked seizures occurring more than 24 hours apart.
  2. A single unprovoked seizure with a high probability (≥60%) of recurrence within the next 10 years.
  3. Clinical or syndromic criteria: in some children and adults, diagnosis is based on genetic data, MRI findings, and EEG results.

Causes of Epilepsy

  • Genetic factors
    Some types of epilepsy are associated with inherited mutations or syndromes. Genetic predisposition may increase seizure risk even without external triggers. Epilepsy can sometimes be passed from parents to children.
  • Perinatal brain injuries
    Brain damage during pregnancy or childbirth is a common cause of epilepsy in children. Causes include hypoxia, bleeding, infections, or head trauma in newborns, which may lead to the formation of seizure foci.
  • Traumatic brain injury
    Severe head injuries, falls, or accidents can damage brain tissue and create epileptic foci. Seizures may occur immediately or years after the injury.
  • Strokes
    Impaired blood flow in the brain (ischemic or hemorrhagic stroke) damages nerve tissue and may trigger seizures, especially in older adults.
  • Brain tumors and CNS infections
    Tumors can irritate neurons and provoke epilepsy. Infections such as meningitis or encephalitis inflame tissue and disrupt electrical brain activity.

Seizure Triggers

  • Sleep deprivation – Lack of sleep or disrupted sleep patterns increases brain excitability.
  • Stress – Emotional tension or stressful situations increase seizure risk.
  • Alcohol – Excessive alcohol intake can disrupt brain function and trigger seizures.
  • Flashing lights  –  Rapidly flickering or intermittent lights (e.g., disco lights, TV, video games) can provoke seizures in photosensitive epilepsy.
  • Missed medications  – Irregular intake of antiepileptic drugs increases the risk of seizure recurrence.

MRI and EEG

MRI

Detects and evaluates structural and morphological brain changes, including congenital malformations, focal cortical dysplasia, perinatal injuries, trauma, strokes, tumors, vascular malformations, scarred/atrophic or inflammatory changes. MRI plays a key role in identifying the cause of epilepsy, determining the epileptogenic zone, and planning treatment, including surgery.

EEG

 Assesses brain electrical activity, detects epileptiform activity and functional abnormalities, determines epilepsy type and form, localizes the epileptogenic focus, and clarifies seizure characteristics and clinical correlation. This is essential for selecting treatment strategy and evaluating therapy effectiveness.

Treatment

Medication
The main and most common treatment method, tailored individually. Drugs are chosen based on seizure type, epilepsy type, patient age, comorbidities, and drug tolerance. The goal is complete seizure control or significant reduction in frequency and severity, with minimal side effects.

Antiepileptic drugs (AEDs)
Modern AEDs effectively control seizures for most patients when therapy is appropriately individualized and regularly monitored.

Surgical treatment
Considered for patients with drug-resistant epilepsy. Surgery is recommended only after comprehensive pre-surgical diagnostics to precisely locate the epileptogenic zone and evaluate potential effectiveness and safety. Surgery can significantly reduce seizure frequency or eliminate seizures in selected patients.

Alternative treatments (devices)
Includes neuromodulation, such as vagus nerve stimulation (VNS therapy), for patients with pharmacoresistant epilepsy when surgery is not possible or advisable. This method can reduce seizure frequency and severity and improve quality of life.

First Aid for Seizures

  1. Stay calm
  2. Place the patient on their side
  3. Do not restrain movements
  4. Do not put objects in the mouth
  5. Call emergency services if the seizure lasts longer than usual

Purple Day

The International Epilepsy Awareness Day is celebrated annually on March 26 to raise public awareness, reduce stigma, and support patients and their families. Worldwide educational events, campaigns, and social initiatives are organized on this day.