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A brain disorder characterized by sudden surges of disorganized electrical impulses in the brain, which leads to seizures (attacks). Many people will have a single seizure at some time in their lives, but this does not mean that they have epilepsy. If a person has epilepsy it means they have had more than one seizure that began in the brain.
Persons most commonly affected: All age groups and both sexes.
Organ or part of body involved: Nervous system
Causes and risk factors: An inherited instability in the functioning of neurones seems to be responsible for the common forms of generalised epilepsy, especially absence attacks, and tonic-clonic seizures where there is a family history of similar disorder. How this genetic defect operates has yet to be established - perhaps the abnormality lies in the structure of the neurone's outer membrane, leading to electrical instability.
Injury to the brain may certainly cause epilepsy. This includes deprivation of oxygen at birth, trauma to the head at any time of life, and stroke (injury to part of the brain caused by blockage or haemorrhage of one of its blood vessels).
Metabolic disturbance can produce generalised seizures through disturbing the normal functioning of neurones. This may occur when there is severe lowering of blood glucose levels, and when there is severe malfunctioning of the liver or kidneys.
Alcohol and drug abuse may cause seizures during intoxication, or when the offending substance is being withdrawn. Withdrawal of certain medications, such as barbiturates and other sedatives, can cause epileptic seizures in those who have taken them for long periods.
Brain tumour is, fortunately, a relatively uncommon cause of epilepsy, but it must be excluded in all patients who develop epilepsy for the first time during adult life. Tumour should also be excluded in children and adolescents in whom the appearances of the EEG test (see below) are not typical of genetic epilepsy, or where these does not seem to be an adequate alternative explanation (such as birth injury).
Prevention: Many people are able to keep their seizures to a minimum by avoiding situations that they know may bring on a seizure, sometimes called triggers. These triggers may include lack of sleep, too much alcohol, emotional upsets or missing medication. Taking care of a person's overall wellbeing is a vital part of the complete management of their epilepsy.