Epilepsy
Epilepsy is a non-communicable chronic disease of the brain that affects people of all ages. About 50 million epilepsy patients worldwide make it one of the most common neurological diseases in the world. The efficacy of epilepsy treatment is about 70%. The disease is characterized by repeated attacks. During epileptic seizures, transient involuntary convulsions (ie, partial or generalized seizures) in one part of the body or the entire body occur, sometimes accompanied by loss of consciousness and urinary incontinence.Seizures are caused by an abnormal discharge of a group of brain cells. Different parts of the brain may be the site of abnormal discharge. Seizures range from very short episodes of loss of consciousness or muscle reflex to severe and persistent convulsions. The frequency of seizures can vary, ranging from less than once a year to several times a day. A seizure does not mean epilepsy (up to 10% of people in the world have an episode in their lifetime). Epilepsy refers to two or more uninterrupted attacks.
Symptoms and signs
The characteristics of seizures vary, depending on the location of the first disorder in the brain and the extent of the disorder. Some transient symptoms may occur, such as loss of consciousness or perception, as well as disturbances in movement, sensation (including vision, hearing and taste), mood or other cognitive functions.
Patients with seizures tend to have more physical problems (such as seizures and bruises) and a higher proportion of psychological conditions, including anxiety and depression. Similarly, epilepsy increased the risk of premature death in patients by as much as 3 times that of the general population, with the highest prevalence (above urban areas) in low- and middle-income countries and rural areas. A significant proportion of the causes of epilepsy-related deaths in these countries are preventable, such as falls, drowning, burns and prolonged attacks.
Incidence
At any given time, the general population has active epilepsy (ie, episodes of persistent or needing treatment) estimated at 4 to 10 people per 1,000 population. An estimated 2.4 million people worldwide are diagnosed with epilepsy each year. In high-income countries, the annual average number of new infections in the general population is 30 to 50 per 100,000. In low-income and middle-income countries, this figure can be up to twice as high.
This may be due to an increased risk of prevalence, such as malaria or neurocysticercosis; higher incidence of road traffic injuries; birth-related injuries; changes in medical infrastructure; and the availability and accessibility of preventive health programs.
Etiology
Epilepsy is not contagious. The most common type is called primary epilepsy. Six out of ten patients have primary epilepsy and the cause is unknown.
Epilepsy with a known etiology is called secondary epilepsy or symptomatic epilepsy. The causes of secondary epilepsy or symptomatic epilepsy may be:
• Brain damage due to prenatal or perinatal damage (eg, hypoxia or trauma during production, low birth weight);
• Congenital abnormalities or genetic disorders associated with brain deformities;
• the head is seriously injured;
• Stroke that limits brain oxygen levels;
• Brain infections such as meningitis, encephalitis, and cysticercosis;
• Some genetic syndromes;
• Brain tumors.
Treatment
Recent studies show that as many as 70% of newly diagnosed epileptic children and adults can successfully treat the disease (ie, complete control of seizures). In addition, there are no seizures after two to five years of successful treatment. About 70% of children and 60% of adults can withdraw from treatment without recurrence. Without sophisticated equipment, it is possible to diagnose and treat most patients with epilepsy at the primary care level. Surgical treatment may be useful in patients who do not respond well to medication.
Prevention
Primary epilepsy cannot be prevented. However, preventive measures may be taken for known causes of secondary epilepsy.
• Preventing head injuries is the most effective way to prevent post-traumatic epilepsy.
• Taking appropriate perinatal care can reduce the number of new cases of epilepsy due to labor injury.
• Use of drugs or other methods to reduce body temperature in children with fever can reduce febrile seizures.
• Central nervous system infections are a common cause of epilepsy in the tropics.
• Eradication of parasites in the environment, and advocacy on how to avoid infection, are effective ways to reduce the global incidence of epilepsy caused by factors such as cysticercosis.
As an initiative launched in 1997, the World Health Organization (WHO), the International League Against Epilepsy and the International Agency for Epilepsy are launching a Global Out of Shadows campaign to provide better information, raise awareness of epilepsy and strengthen public and private sector efforts to improve treatment and reduce the impact of the disease. This study, along with other WHO projects on epilepsy, has shown that there is a simple and cost-effective way to treat epilepsy in under-resourced settings, thereby significantly narrowing the treatment gap. For example, a project in China reduced the treatment gap by more than a year in more than a year and significantly increased the access of patients with epilepsy to medical services.
（Edit according to WHO official information）