Epilepsy

Epilepsy is a chronic noncommunicable ailment of the brain that impacts humans of all ages.

Approximately 50 million people global have epilepsy, making it one of the maximum not unusual neurological sicknesses globally.

Nearly 80% of the human beings with epilepsy stay in low- and middle-earnings countries.

People with epilepsy reply to treatment about 70% of the time.

About three fourths of human beings with epilepsy dwelling in low- and center- earnings countries do no longer get the treatment they want.

In many components of the world, human beings with epilepsy and their families suffer from stigma and discrimination.

Epilepsy is a continual ailment of the mind that influences people international. It is characterized with the aid of recurrent seizures, which might be short episodes of involuntary movement that could involve a part of the body (partial) or the complete frame (generalized), and are once in a while observed by lack of recognition and manipulate of bowel or bladder function.

Seizure episodes are a result of immoderate electrical discharges in a group of mind cells. Different components of the mind may be the website of such discharges. Seizures can range from the briefest lapses of attention or muscle jerks to severe and prolonged convulsions. Seizures also can vary in frequency, from less than 1 consistent with year to several consistent with day.

One seizure does not symbolize epilepsy (up to 10% of human beings worldwide have one seizure during their lifetime). Epilepsy is defined as having 2 or extra unprovoked seizures. Epilepsy is one of the international’s oldest diagnosed conditions, with written records dating returned to 4000 BC. Fear, misunderstanding, discrimination and social stigma have surrounded epilepsy for hundreds of years. This stigma continues in many nations these days and can impact at the fine of life for humans with the sickness and their households.

Signs and symptoms

Characteristics of seizures vary and depend on wherein in the mind the disturbance first starts offevolved, and how some distance it spreads. Temporary symptoms arise, which include lack of cognizance or recognition, and disturbances of motion, sensation (along with vision, listening to and taste), mood, or different cognitive features.

People with seizures tend to have greater bodily troubles (which includes fractures and bruising from accidents related to seizures), as well as higher charges of mental conditions, inclusive of anxiety and despair. Similarly, the hazard of untimely loss of life in people with epilepsy is up to three instances better than the general population, with the best quotes found in low- and center-income international locations and rural as opposed to urban areas.

A high-quality proportion of the reasons of dying associated with epilepsy in low- and center-profits international locations are doubtlessly preventable, such as falls, drowning, burns and prolonged seizures.

Rates of ailment

Approximately 50 million humans presently live with epilepsy international. The expected proportion of the general population with lively epilepsy (i.E. Continuing seizures or with the need for remedy) at a given time is among four and 10 in step with 1000 humans. However, a few studies in low- and center-earnings countries advise that the proportion is tons higher, between 7 and 14 in step with a thousand people.

Globally, an expected 2.4 million people are recognized with epilepsy each yr. In high-profits international locations, annual new cases are among 30 and 50 consistent with one hundred 000 human beings inside the trendy population. In low- and middle-income countries, this figure may be up to two times better.

This is probably because of the increased risk of endemic situations consisting of malaria or neurocysticercosis; the better occurrence of street visitors injuries; start-related accidents; and variations in clinical infrastructure, availability of preventative health programmes and handy care. Close to eighty% of people with epilepsy stay in low- and center-earnings international locations.

Causes

Epilepsy isn't contagious. The most common sort of epilepsy, which affects 6 out of 10 humans with the disease, is referred to as idiopathic epilepsy and has no identifiable cause.

Epilepsy with a known purpose is referred to as secondary epilepsy, or symptomatic epilepsy. The causes of secondary (or symptomatic) epilepsy might be:

mind damage from prenatal or perinatal injuries (e.G. A loss of oxygen or trauma for the duration of beginning, low start weight),

congenital abnormalities or genetic situations with related mind malformations,

a severe head damage,

a stroke that restricts the quantity of oxygen to the brain,

an infection of the mind including meningitis, encephalitis, neurocysticercosis,

certain genetic syndromes,

a mind tumor.

Treatment

Epilepsy can be handled without problems and cheaply with inexpensive day by day remedy that fees as low as US$ 5 in line with 12 months. Recent studies in each low- and middle-income countries have shown that up to 70% of youngsters and adults with epilepsy may be efficaciously treated (i.E. Their seizures completely controlled) with anti-epileptic drugs (AEDs). Furthermore, after 2 to five years of a success treatment and being seizure-free, capsules may be withdrawn in approximately 70% of children and 60% of adults without next relapse.

In low- and middle-earnings international locations, about 3 fourths of people with epilepsy won't receive the treatment they want. This is referred to as the “remedy hole”.

In many low- and center-income international locations, there's low availability of AEDs. A current examine located the average availability of usual antiepileptic drug treatments inside the public region of low- and center-profits nations to be less than 50%. This might also act as a barrier to getting access to treatment.

It is possible to diagnose and deal with most of the people with epilepsy on the primary health- care stage with out the use of sophisticated equipment.

WHO demonstration initiatives have indicated that education number one health-care carriers to diagnose and deal with epilepsy can efficaciously reduce the epilepsy remedy gap. However, the lack of skilled fitness-care carriers can act as a barrier to remedy for humans with epilepsy.

Surgical therapy might be beneficial to patients who respond poorly to drug treatments.

Prevention

Idiopathic epilepsy isn't preventable. However, preventive measures may be implemented to the recognized reasons of secondary epilepsy.

Preventing head harm is the handiest way to prevent submit-traumatic epilepsy.

Adequate perinatal care can lessen new cases of epilepsy caused by birth injury.

The use of medicine and other techniques to lower the body temperature of a feverish child can lessen the risk of febrile seizures.

Central fearful gadget infections are not unusual reasons of epilepsy in tropical areas, in which many low- and center-profits international locations are concentrated.

Elimination of parasites in these environments and education on a way to avoid infections can be effective methods to reduce epilepsy worldwide, for example the ones instances due to neurocysticercosis.

Social and monetary influences

Epilepsy money owed for 0.6%, of the worldwide burden of disorder, a time-based measure that combines years of lifestyles misplaced due to untimely mortality and time lived in less than complete fitness. Epilepsy has massive financial implications in phrases of health care needs, untimely dying and lost paintings productivity.

An Indian study conducted in 1998 calculated that the fee in step with affected person of epilepsy remedy was as excessive as 88.2% of the u . S .’s according to capita Gross National Product (GNP), and epilepsy-associated prices, which included medical prices, travel, and lost work time, exceeded $2.6 billion/yr (2013 USD).(1)

Although the social effects range from united states of america to usa, the discrimination and social stigma that surround epilepsy global are often greater difficult to overcome than the seizures themselves. People living with epilepsy can be targets of prejudice. The stigma of the ailment can discourage people from in search of remedy for signs and symptoms, in order to keep away from becoming recognized with the ailment.

Human rights

People with epilepsy can revel in decreased get admission to to health and existence coverage, a withholding of the opportunity to acquire a driving license, and barriers to enter particular occupations, among different boundaries. In many nations legislation displays centuries of misunderstanding about epilepsy. For instance:

In each China and India, epilepsy is commonly considered as a reason for prohibiting or annulling marriages.

In the UK, laws which authorized the annulment of a marriage on the grounds of epilepsy were now not amended until 1971.

In the United States of America, until the 1970s, it turned into legal to disclaim human beings with seizures get admission to to restaurants, theatres, recreational centres and other public buildings.

Legislation primarily based on internationally ordinary human rights requirements can save you discrimination and rights violations, improve access to fitness-care services, and lift the first-rate of lifestyles for human beings with epilepsy.

WHO reaction

WHO and its partners understand that epilepsy is a main public fitness subject. As an initiative established in 1997, WHO, the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE) are wearing out a worldwide marketing campaign – “Out of the Shadows” – to provide better records and lift recognition about epilepsy and strengthen public and private efforts to enhance care and reduce the disease's effect.

This, in addition to other WHO initiatives on epilepsy, have shown that there are easy, cost-effective methods to treat epilepsy in useful resource-poor settings, thereby substantially reducing treatment gaps. For instance, a mission performed in China led to treatment hole reductions of thirteen% over 1 12 months and sizable upgrades in get entry to to take care of humans with epilepsy.

Projects which intention to lessen the treatment gap and morbidity of human beings with epilepsy, to teach and train fitness specialists, to dispel stigma, to pick out potential prevention techniques, and to develop fashions integrating epilepsy control into local fitness systems are ongoing in many nations.

In particular, the WHO Programme on Reducing the Epilepsy Treatment Gap and the Mental Health Gap Action Programme (mhGAP) currently are seeking to achieve those goals in Ghana, Mozambique, Myanmar and Viet Nam. These projects combine numerous innovative strategies. They recognition on increasing the talents of primary care and non-expert fitness experts on the community stage to diagnose, deal with and observe up human beings with epilepsy. It will mobilize the network to better guide human beings with epilepsy and their families.

Key information

Epilepsy is a chronic noncommunicable ailment of the brain that impacts humans of all ages.

Approximately 50 million people global have epilepsy, making it one of the maximum not unusual neurological sicknesses globally.

Nearly 80% of the human beings with epilepsy stay in low- and middle-earnings countries.

People with epilepsy reply to treatment about 70% of the time.

About three fourths of human beings with epilepsy dwelling in low- and center- earnings countries do no longer get the treatment they want.

In many components of the world, human beings with epilepsy and their families suffer from stigma and discrimination.

Epilepsy is a continual ailment of the mind that influences people international. It is characterized with the aid of recurrent seizures, which might be short episodes of involuntary movement that could involve a part of the body (partial) or the complete frame (generalized), and are once in a while observed by lack of recognition and manipulate of bowel or bladder function.

Seizure episodes are a result of immoderate electrical discharges in a group of mind cells. Different components of the mind may be the website of such discharges. Seizures can range from the briefest lapses of attention or muscle jerks to severe and prolonged convulsions. Seizures also can vary in frequency, from less than 1 consistent with year to several consistent with day.

One seizure does not symbolize epilepsy (up to 10% of human beings worldwide have one seizure during their lifetime). Epilepsy is defined as having 2 or extra unprovoked seizures. Epilepsy is one of the international’s oldest diagnosed conditions, with written records dating returned to 4000 BC. Fear, misunderstanding, discrimination and social stigma have surrounded epilepsy for hundreds of years. This stigma continues in many nations these days and can impact at the fine of life for humans with the sickness and their households.

Signs and symptoms

Characteristics of seizures vary and depend on wherein in the mind the disturbance first starts offevolved, and how some distance it spreads. Temporary symptoms arise, which include lack of cognizance or recognition, and disturbances of motion, sensation (along with vision, listening to and taste), mood, or different cognitive features.

People with seizures tend to have greater bodily troubles (which includes fractures and bruising from accidents related to seizures), as well as higher charges of mental conditions, inclusive of anxiety and despair. Similarly, the hazard of untimely loss of life in people with epilepsy is up to three instances better than the general population, with the best quotes found in low- and center-income international locations and rural as opposed to urban areas.

A high-quality proportion of the reasons of dying associated with epilepsy in low- and center-profits international locations are doubtlessly preventable, such as falls, drowning, burns and prolonged seizures.

Rates of ailment

Approximately 50 million humans presently live with epilepsy international. The expected proportion of the general population with lively epilepsy (i.E. Continuing seizures or with the need for remedy) at a given time is among four and 10 in step with 1000 humans. However, a few studies in low- and center-earnings countries advise that the proportion is tons higher, between 7 and 14 in step with a thousand people.

Globally, an expected 2.4 million people are recognized with epilepsy each yr. In high-profits international locations, annual new cases are among 30 and 50 consistent with one hundred 000 human beings inside the trendy population. In low- and middle-income countries, this figure may be up to two times better.

This is probably because of the increased risk of endemic situations consisting of malaria or neurocysticercosis; the better occurrence of street visitors injuries; start-related accidents; and variations in clinical infrastructure, availability of preventative health programmes and handy care. Close to eighty% of people with epilepsy stay in low- and center-earnings international locations.

Causes

Epilepsy isn't contagious. The most common sort of epilepsy, which affects 6 out of 10 humans with the disease, is referred to as idiopathic epilepsy and has no identifiable cause.

Epilepsy with a known purpose is referred to as secondary epilepsy, or symptomatic epilepsy. The causes of secondary (or symptomatic) epilepsy might be:

mind damage from prenatal or perinatal injuries (e.G. A loss of oxygen or trauma for the duration of beginning, low start weight),

congenital abnormalities or genetic situations with related mind malformations,

a severe head damage,

a stroke that restricts the quantity of oxygen to the brain,

an infection of the mind including meningitis, encephalitis, neurocysticercosis,

certain genetic syndromes,

a mind tumor.

Treatment

Epilepsy can be handled without problems and cheaply with inexpensive day by day remedy that fees as low as US$ 5 in line with 12 months. Recent studies in each low- and middle-income countries have shown that up to 70% of youngsters and adults with epilepsy may be efficaciously treated (i.E. Their seizures completely controlled) with anti-epileptic drugs (AEDs). Furthermore, after 2 to five years of a success treatment and being seizure-free, capsules may be withdrawn in approximately 70% of children and 60% of adults without next relapse.

In low- and middle-earnings international locations, about 3 fourths of people with epilepsy won't receive the treatment they want. This is referred to as the “remedy hole”.

In many low- and center-income international locations, there's low availability of AEDs. A current examine located the average availability of usual antiepileptic drug treatments inside the public region of low- and center-profits nations to be less than 50%. This might also act as a barrier to getting access to treatment.

It is possible to diagnose and deal with most of the people with epilepsy on the primary health- care stage with out the use of sophisticated equipment.

WHO demonstration initiatives have indicated that education number one health-care carriers to diagnose and deal with epilepsy can efficaciously reduce the epilepsy remedy gap. However, the lack of skilled fitness-care carriers can act as a barrier to remedy for humans with epilepsy.

Surgical therapy might be beneficial to patients who respond poorly to drug treatments.

Prevention

Idiopathic epilepsy isn't preventable. However, preventive measures may be implemented to the recognized reasons of secondary epilepsy.

Preventing head harm is the handiest way to prevent submit-traumatic epilepsy.

Adequate perinatal care can lessen new cases of epilepsy caused by birth injury.

The use of medicine and other techniques to lower the body temperature of a feverish child can lessen the risk of febrile seizures.

Central fearful gadget infections are not unusual reasons of epilepsy in tropical areas, in which many low- and center-profits international locations are concentrated.

Elimination of parasites in these environments and education on a way to avoid infections can be effective methods to reduce epilepsy worldwide, for example the ones instances due to neurocysticercosis.

Social and monetary influences

Epilepsy money owed for 0.6%, of the worldwide burden of disorder, a time-based measure that combines years of lifestyles misplaced due to untimely mortality and time lived in less than complete fitness. Epilepsy has massive financial implications in phrases of health care needs, untimely dying and lost paintings productivity.

An Indian study conducted in 1998 calculated that the fee in step with affected person of epilepsy remedy was as excessive as 88.2% of the u . S .’s according to capita Gross National Product (GNP), and epilepsy-associated prices, which included medical prices, travel, and lost work time, exceeded $2.6 billion/yr (2013 USD).(1)

Although the social effects range from united states of america to usa, the discrimination and social stigma that surround epilepsy global are often greater difficult to overcome than the seizures themselves. People living with epilepsy can be targets of prejudice. The stigma of the ailment can discourage people from in search of remedy for signs and symptoms, in order to keep away from becoming recognized with the ailment.

Human rights

People with epilepsy can revel in decreased get admission to to health and existence coverage, a withholding of the opportunity to acquire a driving license, and barriers to enter particular occupations, among different boundaries. In many nations legislation displays centuries of misunderstanding about epilepsy. For instance:

In each China and India, epilepsy is commonly considered as a reason for prohibiting or annulling marriages.

In the UK, laws which authorized the annulment of a marriage on the grounds of epilepsy were now not amended until 1971.

In the United States of America, until the 1970s, it turned into legal to disclaim human beings with seizures get admission to to restaurants, theatres, recreational centres and other public buildings.

Legislation primarily based on internationally ordinary human rights requirements can save you discrimination and rights violations, improve access to fitness-care services, and lift the first-rate of lifestyles for human beings with epilepsy.

WHO reaction

WHO and its partners understand that epilepsy is a main public fitness subject. As an initiative established in 1997, WHO, the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE) are wearing out a worldwide marketing campaign – “Out of the Shadows” – to provide better records and lift recognition about epilepsy and strengthen public and private efforts to enhance care and reduce the disease's effect.

This, in addition to other WHO initiatives on epilepsy, have shown that there are easy, cost-effective methods to treat epilepsy in useful resource-poor settings, thereby substantially reducing treatment gaps. For instance, a mission performed in China led to treatment hole reductions of thirteen% over 1 12 months and sizable upgrades in get entry to to take care of humans with epilepsy.

Projects which intention to lessen the treatment gap and morbidity of human beings with epilepsy, to teach and train fitness specialists, to dispel stigma, to pick out potential prevention techniques, and to develop fashions integrating epilepsy control into local fitness systems are ongoing in many nations.

In particular, the WHO Programme on Reducing the Epilepsy Treatment Gap and the Mental Health Gap Action Programme (mhGAP) currently are seeking to achieve those goals in Ghana, Mozambique, Myanmar and Viet Nam. These projects combine numerous innovative strategies. They recognition on increasing the talents of primary care and non-expert fitness experts on the community stage to diagnose, deal with and observe up human beings with epilepsy. It will mobilize the network to better guide human beings with epilepsy and their families.

@dammylohar