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health.Epilepsy is not one single condition. Epilepsy is defined as a spectrum of disorders that involve the central nervous system (brain and spine). In epilepsy, abnormal brainwaves disturb brain activity, leading to seizures. Seizures may cause people to have unusual sensations or emotions, behave in unusual ways, or experience convulsions or loss of consciousness. Brain damage, illness, and irregular brain development can all cause abnormal brainwaves that lead to seizures. Approximately half of all people who have had one seizure will have more. However, in order to be diagnosed with epilepsy, a person must have had more than one seizure, and doctors must consider it likely that they will continue to have seizures. Some forms of epilepsy only last for a limited time, while others are lifelong. There are many treatments available for epilepsy; about 70 percent of people with seizures can control them effectively with medication. There are many different types of seizures, and some people with epilepsy will experience more than one type. Learn more about epilepsy symptoms and seizure types. The History of Epilepsy People have been aware of epilepsy and seizures for millennia. A Babylonian medical textbook made up of 40 tablets and dating to 2000 BCE contains a chapter that accurately describes many of the different types of seizures known today. However, seizures were thought to be supernatural in cause – each seizure type was associated with a different evil spirit or angry god – so the treatments prescribed were spiritual. By the 5th century BCE, the Greeks still considered epilepsy a "sacred" disease. Yet, in the writing of Hippocrates, the ancient physician described epilepsy as a brain disorder – a radical idea for the time. He recommended physical treatments while also recognizing that if the seizures became chronic, the disorder was incurable. The word "epilepsy" comes from the Greek word epilepsia, meaning "to seize" or "to take hold of." Despite Hippocrates’ writings, epilepsy continued to be considered a supernatural condition for the next two millennia. People with epilepsy were subjects of immense social stigma, treated as outcasts and even punished as witches. In many places, people who suffered seizures were prevented from going to school, working, marrying, and having children. There were a few men with epilepsy who occupied prominent positions – including Julius Caesar, Tsar Peter the Great of Russia, Pope Pius IX, and Fyodor Dostoevsky – but most people with epilepsy were prevented from living as full members of society. During the Renaissance, some scientists tried to prove epilepsy was a physical, not spiritual, illness. It wasn’t until the 19th century when neurology became a recognized medical discipline (separate from psychiatry), and the idea of epilepsy as a brain disorder took hold in North America and Europe. In 1857, Sir Charles Lacock introduced bromide as the first anti-epileptic drug (AED). In the mid-to-late 1800s, a variety of epilepsy colonies and treatment facilities opened. In 1873, a British neurologist named John Hughlings Jackson first described epilepsy as we understand it today. Jackson proved that seizures are caused by sudden, brief electrochemical discharges of energy in the brain. In 1909, the International League Against Epilepsy was founded as a global professional organization of epileptologists. By the 1920s, Hans Berger, a German psychiatrist, had developed the electroencephalograph (EEG) to measure brainwaves. It showed that each type of seizure is associated with a different brainwave pattern. The EEG also aided in the discovery that specific sites in the brain were responsible for seizures and expanded the potential for surgical treatments. Surgery became a more widely available option by the 1950s. Phenobarbital was identified as an AED in 1912, and Phenytoin (sold under the brand names Dilantin and Phenytek) was developed in 1938. Both drugs continue to be used today. Carbamazepine (sold under the brand names Tegretol and Carbatrol) was identified in 1953. An accelerated drug discovery process began in the 1960s as scientists gained a better understanding of the brain. Keppra (Levetiracetam) was approved by the U.S. Food and Drug Administration (FDA) in 1999. Several newer drugs, including Vimpat (Lacosamide), Briviact (Brivaracetam), and Aptiom (Eslicarbazepine acetate) have been introduced in past 10 years. Other promising medications are in the pipeline. Neuroimaging capabilities have also improved over the past few decades. Magnetic resonance imaging (MRI), computer tomography (CT) scans, and other techniques are able to detect more and more subtle brain lesions responsible for epilepsy. The stigma around epilepsy has lessened as more people are able to effectively treat their seizures; however, epilepsy largely remains an "invisible" illness. Millions of people in developing countries do not have access to AEDs, and stigma and discrimination are still widespread, especially in places where people still believe that seizures have a supernatural cause. How Common Is Epilepsy? Males and females of all backgrounds, races, ethnicities, and ages are equally affected by epilepsy. It is estimated that epilepsy affects 1 percent of the population of the United States and over 65 million people worldwide, making it one of the most common neurological disorders. Approximately 45,000 children under the age of 18 are diagnosed with epilepsy every year in the U.S., and roughly 10.5 million children worldwide live with epilepsy.
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