What is a Seizure?
	A Seizure is an event during which a person experiences alteration or loss of consciousness, has some abnormal involuntary movements involving his/her face, arm, leg etc., and may fall to the ground, pass urine without his/her knowledge, bite his/her tongue or cause other injuries.
	A Seizure (often called fit, attack, turn or blackout) is an isolated episode which could happen to anyone if circumstances are appropriate.
What is Epilepsy?
	Epilepsy means having a tendency to experience repeated spontaneous seizures.
	Epilepsy is not just one condition and it is not always easy to give an explanation in each individual case of why seizures begin or why they continue to occur. There are many misconceptions about this condition. However, it may be noted that it is not an illness or disease.
Why do seizures occur?
	Seizures occur when ordinary highly complex brain activity is suddenly disrupted.
	Recurrent seizures (Epilepsy) occur due to intrinsic disturbance of neuronal function within the brain.
	Any person’s brain has the capacity to produce a seizure if the circumstances are appropriate. Most brains are not likely to do this spontaneously and can therefore, be said to have a high “seizure threshold” or high resistance to seizures. Individuals vary as to their threshold and it is probably due to their genetic characteristics. A person with a low threshold might develop epilepsy spontaneously without other factors being involved. Sometimes a predisposition to seizures can be seen in some families where several members are affected.
	But the genetics of epilepsy are not straightforward. In some individuals, the existing seizure threshold may be lowered if the brain is subjected to unusual stimulation (such as certain frequencies of flickering light and some drugs) or is injured. If the injury is severe e.g. due to road traffic accidents, infections, birth trauma, stroke or tumor, then epilepsy may develop as a consequence.
	Many individuals attribute the onset of their seizures to some relatively minor event such as a blow to the head or an emotional upset. Although these cannot be completely discounted, in such cases it is likely that family predisposition to seizures plays a more important role.
How can seizures be described?
	Not all seizures involve convulsions and many different terms are used. It is important to use terms which describe what is happening during the seizure.
	A person with epilepsy can experience more than one type of seizure, but the pattern of seizures tends to remain fairly constant in an individual
	Although epilepsy can be classified in different ways, the International Classification of Seizures (Published by the International League Against Epilepsy) is the most commonly used.
GENERALISED SEIZURES:
	In this type, the whole of the brain is involved and consciousness is lost. The seizure may then take one of the following forms:
	The most dramatic form is the generalized tonic clonic convulsive seizure (still sometimes called a ‘grand mal’ seizure) in which the person becomes rigid, and may fall if standing. The muscles then relax and tighten rhythmically causing the person to convulse. Breathing is labored and they may be incontinent. Other types of generalized seizures include:   Tonic in which there is general stiffening of muscles without rhythmic jerking. The person may fall to the ground if standing with consequent risk of injury.   Atonic (also known as drop attacks) in which there is a sudden loss of muscle tone, again causing the person to fall if standing.   Myoclonic in which abrupt jerking of the limbs occurs. These often happen within a short time of waking up, either on their own or in the company with other forms of generalized seizures.   Absences in which there is a brief interruption of consciousness without any other signs, except perhaps for fluttering of the eyelids. These occur most commonly in children and are still sometimes known as “petit mal”.
PARTIAL SEIZURES:
	During a partial seizure, the disturbance in brain activity begins in or involves a distinct area of the brain. The nature of these seizures is usually determined by the function of the part of the brain that is involved. Partial seizures are sometimes known as “focal”.
	There are basically three types of partial seizures - Simple partial, complex partial and secondarily generalized.
	In simple partial seizures, consciousness is not impaired and the seizure is confirmed to either rhythmical twitching of one limb, or part of a limb, or to unusual tastes or sensations such as pins and needles in a distinct part of the body. Simple partial seizures sometimes develop into other sorts of seizures and they are often referred to as a “warning” or “aura”.
	Complex partial seizures differ from single partial seizure in that consciousness is affected. The seizures may then be characterized by a change in awareness as well as “semi-purposive” movements such as fiddling with clothes or nearby objects, wandering about and general confusion. Complex partial seizures usually involve the temporal lobes of the brain, however they can also affect the frontal and parietal lobes.
	In some people, either of these seizures may spread to involve the whole of the brain and if this happens it is called a secondarily generalized seizure.
Are there different types of Epilepsy
	Epilepsy may take many forms and just knowing that a person has ‘epilepsy’ gives very little useful information about that individual.
	Epilepsy can broadly be divided into two categories, both producing a number of types of seizures.
IDIOPATHIC EPILEPSY
	In this type, there is no clear environmental cause for the epilepsy and it is presumed that genetic factors predominate. There are usually no other handicaps and the EEG is often normal between seizures. The response to drug treatment is usually good.
SYMPTOMATIC EPILEPSY
	This usually develops as a result of some structural abnormality in the brain either present at birth or occasionally later in life . Other disabilities may be caused by this same abnormality (physical, intellectual or psychiatric). EEG investigations may reveal the abnormality and the response to drug treatment is variable in different individuals.
	Some individuals have cryptogenic epilepsy, which is epilepsy in which no cause can be found, but a cause is suspected.
How many people have Epilepsy?
	Epilepsy is the most common serious neurological disorder affecting people of all ages. A prevalence rate of 0.5% (1 in 200) is usually quoted as a minimum prevalence.
	Anyone can develop epilepsy; it occurs in all ages, races and social classes. Seizures tend to start in infancy or by late adolescence; the incidence rises again after 65.
How is a diagnosis of Epilepsy made?
	Unlike most neurological disorders, there may be no physical signs. The diagnosis is, therefore, made on the basis of a history of more than one epileptic seizure. An accurate eye-witness account is crucial to making a correct diagnosis, as the person experiencing the seizure usually has no recollection of what has happened.
	A number of investigations may provide additional information, although these tests do not make the diagnosis of epilepsy. For detailed information see the leaflet “Diagnosing Epilepsy”
Can Epilepsy be treated?
	Yes. But the success depends on many factors; type of epilepsy, accuracy of diagnosis, accuracy of treatment, compliance, associated handicaps and social problems.
	With appropriate drug treatment, seizures can be completely controlled in the majority of people. In some, the tendency to have seizures diminishes with time, but maximum control should still be sought as early as possible. It may be necessary to take anti-epileptic drugs for a period of years even if seizures have stopped.
	Some people, however, continue to have seizures despite appropriate treatment. A small portion of such people whose seizures can be shown to arise from activity in one discrete area of the brain. Even if seizures continue, it should be possible to adjust the drug regime so that the condition remains stable, to allow the person to function at an optimal level.
	Many people are able to keep their seizures to a minimum by avoiding situations which they know may bring on a seizure. These may include lack of sleep, too much alcohol, emotional upsets or not taking tablets as directed. Practising such “self care” is a vital part of overall management of epilepsy.
Is Epilepsy a disability ?
	If seizures can be completely controlled, and if the person can achieve a high level of confidence and self-esteem, then epilepsy should present no real obstacles to a full life. However, having seizures for the first time, and being told that the diagnosis is “epilepsy” (about which there may be many misconceptions in the individual’s mind) can be very upsetting.
	Careful counselling and health education can do much to alleviate anxiety for the individual and the family.
	If the person continues to have seizures, then there may be difficulties in many aspects of daily living. But even in this situation, good psychological health can help minimize physical problems which only occur from time to time. Individuals should be helped not to blame everything on their epilepsy, and there should be an emphasis on abilities rather than the extent of the disability.
	Merely labeling people as “epileptics" on the basis of a medical diagnosis of epilepsy ignores the rest of their attributes and characteristics, both good and bad, and should be avoided.