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Epilepsy: Clinical, Epidemiological, and Therapeutical Aspects

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Surgical Treatment of Epilepsies

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Abstract

Epilepsy is one of the most common neurological disorders affecting almost 1% of the population. According to the International League Against Epilepsy (ILAE), it is defined by any of the following conditions: (1) two unprovoked seizures occurring more than 24 h apart; (2) a single unprovoked seizure, if recurrence risk is high (at least 60% over the next 10 years), (3) a diagnosis of an epilepsy syndrome. The classification and terminology of seizure types have been updated by the ILAE in 2017. The incidence of epilepsy presents a first peak in early life. It remains relatively high in childhood and adolescence, decreases between the third and sixth decades, and presents a second peak in older age. Epilepsy has numerous neurobiological, cognitive, and psychosocial consequences. Patients with epilepsy suffer from restricted mobility, limited job options, and emotional stress. Epilepsy patients are exposed to multiple risks including status epilepticus, traumatic injury, and sudden unexpected death in epilepsy (SUDEP). Comorbidities as observed in half of epilepsy patients include psychiatric and somatic disorders. In 1997, the WHO in conjunction with the ILAE and the International Bureau for Epilepsy launched the Global Campaign Against Epilepsy, which resulted in the 2015 World Health Assembly urging all states to address the specific needs of people with epilepsy. One-third of all epilepsy patients have persistent seizures despite optimal medical treatment. In selected individuals with drug-resistant focal epilepsy, surgery has proven to be an effective option providing the unique chance to cure epilepsy as demonstrated by three randomized controlled trials.

People think that epilepsy is divine simply because they don’t have any idea what causes epilepsy. But I believe that someday we will understand what causes epilepsy, and at that moment, we will cease to believe that it’s divine. And so it is with everything in the universe.

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  1. Freiburg im Breisgau, Baden-Württemberg, Germany

    Josef Zentner

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Zentner, J. (2020). Epilepsy: Clinical, Epidemiological, and Therapeutical Aspects. In: Surgical Treatment of Epilepsies. Springer, Cham. https://doi.org/10.1007/978-3-030-48748-5_2

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