Epilepsy: epidemiology, classification and natural history

Angus-Leppan, Heather; Parsons, Linda M.

doi:10.1016/j.mpmed.2008.08.003

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Volume 36, Issue 11 , Pages 571-578, November 2008

Epilepsy: epidemiology, classification and natural history

Heather Angus-Leppan MSc (Ep) MD FRACP FRCP is a Consultant Neurologist, Honorary Senior Lecturer and Epilepsy Lead at the Royal Free Hospital, Pond Street, London, UK. She is the Honorary Assistant Secretary of the Association of British Neurologists, Honorary Secretary of the Neurosciences Section of the Royal Society of Medicine and current Chair of the Map of Medicine Epilepsy Group, UK. Competing interests: none declared

Linda M Parsons MD FRCP is a Consultant Neurologist at Royal Free, Luton and Dunstable and St Albans City Hospitals, UK. She qualified from Sheffield University and trained in Neurology in Birmingham and London, UK. She has a longstanding interest in epilepsy and currently sits on the steering committee for the UK Epilepsy and Pregnancy Register. Competing interests: none declared

Abstract

Epilepsy is a paroxysmal disorder in which a person has two or more seizures. A seizure results from an abnormal electrical discharge and the clinical manifestations vary greatly. The peak incidence is in younger and older people. Childhood febrile convulsions occur in about 5% of the population, and there is a 2–5% lifetime prevalence for one or more seizures. Two-thirds of patients go into remission. The minority are refractory and need reassessment of both the diagnosis and management. Epilepsy is associated with at least twice the standardized mortality ratio. In the economically disadvantaged world epilepsy is even more common, compounded by far fewer resources to deal with it. The different patterns and causation are summarized.

Keywords: classification, cryptogenic, epilepsy, focal, idiopathic, primary, SUDEP, symptomatic