Epilepsy is one of the most common brain disorders affecting about 50 million people worldwide. Our brain sends electrical commands to our body which then acts accordingly. Disruption in this electrical activity leads to a change in a person’s physical and behavioural activities with alteration in level of awareness. This constitutes a seizure, the clinical symptoms of epilepsy.

The causes of epilepsy can broadly be labelled under the headings of structural, infectious, metabolic, immune and unknown. Genetic predisposition can be a cause of epilepsy but is not very common.

1. In 60% of people with epilepsy no cause is found and thus called ‘idiopathic’ epilepsy.
2. Epilepsy with an overt cause is called ‘symptomatic’ epilepsy. Causes include:

- Brain damage from prenatal or perinatal causes e.g. a low/loss of oxygen, birth trauma, low birth weight, kernicterus (severe jaundice at birth)
- Congenital abnormalities with associated brain malformations like Cerebral Palsy, Down syndrome etc.
- Brain infection; tuberculosis, meningitis, encephalitis
- Brain tumours
- Stroke, causing brain scarring
- Severe head injuries like in road traffic accidents, fall from height
- Neurodegenerative diseases

Epilepsy is usually treated by primary care doctors (family physicians, general practitioners), psychiatrists, paediatricians, neurologists or epileptologists (neurologist specializing in epilepsy). Epileptologists have a major role when there is complexity in diagnosis or in seizure control and treatment.

The primary method of diagnosing epilepsy is by doctors taking a detailed description of the seizures from the witness and patient, along with present and past medical history. They may ask for some tests to help give additional information about the type and cause of the epilepsy or rule out any other conditions that can seizures. Home video recording on mobile phones is very helpful.

Epilepsy is treatable disorder like high blood pressure and diabetes. With medications one can become seizure free and 60% of them can go off medicines. However, it is your doctor who will decide and advice how to slowly taper off as sudden withdrawal can prove fatal.