Epilepsy is a disorder where a person has recurrent seizures as the result of a sudden and uncontrolled electrical current being released in the brain. When a seizure happens, the normal pattern of the brain's electrical impulses is disrupted, and the impulses instead rapidly fire all at once. During a seizure neurons can fire up to five hundred times a second- more than six times the normal rate, causing a seizure to happen.
Epilepsy is the most common neurological condition, affecting around four percent of the general population. The kind of seizures caused by epilepsy can vary depending on the type of epilepsy and what part of the brain is affected. There are over 40 different types of seizures, ranging from a brief lapse in attention or confusion to severe prolonged convulsions. The frequency of seizures can also vary, from one a year to several per day.
Seizures can effect a person's:
- sensation and feeling
- awareness and consciousness
- or movement.
Seizures vary greatly and can be very brief, or last up to three minutes. There is also a state called status epilepticus, where a person has multiple seizures without regaining consciousness in between. Most seizures last around two minutes. Having a seizure does not mean a person has epilepsy, a diagnosis of epilepsy is made by a medical professional if the seizures are recurring.
65 million people worldwide have epilepsy, 80% of them in developing countries.
65% of diagnosis of epilepsy have no known cause
1 in 200 children live with epilepsy
Causes and treatment
The cause of epilepsy is unknown in around 65 percent of cases. In these cases, it is thought that there is a genetic factor in the development of the condition. For the remaining 35 percent of cases, the most common causes are:
- Structurally different parts of the brain at birth
- Brain infection that leaves scarring
- Trauma or injury to the head
- Another disability that increases likelihood, such as Autism Spectrum Disorder, Down's syndrome or tuberous sclerosis.
Treatment with medication can relieve the symptoms of epilepsy in around 60-70 percent of people, meaning they are seizure free. In addition to this, around 70 percent of people can be taken off medication after 2 to 5 years without the seizures returning. For people who have found medication to be ineffective, epilepsy surgery is sometimes an option. Over half the number of people who have surgery become seizure free long term, and many others have fewer or less severe seizures after surgery.
How the Florey is making a difference
Epilepsy Imaging: Through the use of advanced MRI imaging methods we continue to make major advances in understanding epilepsy. These advances are rapidly translated into improved patient care through Victorian Epilepsy Centres’ comprehensive epilepsy programs; one of these is at the Austin Hospital in Heidelberg where the Florey imaging team is an integral part of the investigation and treatment of epilepsy in patients.
Human brain structure and function: In order to better understand the cognitive impacts of epilepsy, our scientists use advanced imaging techniques to map the functional effect of epilepsy in several cognitive domains. One of the key issues in brain surgery during removal of an epileptic focus is potential damage to the normal functioning of the patient. For the best possible outcome, we need a good understanding of how normal brain function is organised, and how this may be perturbed in a person with epilepsy. Our scientists have mapped disease-related changes in brain regions responsible for language, memory, music (singing), and are also examining changes in these domains post- surgery.
Ion channels and disease: Genetics plays a major role in epilepsy. In particular, subtle changes in the properties of mutated ion channel proteins have been identified as the cause of many cases of human epilepsy. Using advanced electrophysiological and biophysical tools, the group’s efforts focus on exposing the fundamental physiological changes that predispose people to epilepsy, thereby revealing methods and approaches for diagnosis and therapy.
Neurobiology of epilepsy: The goal of the multi-disciplinary Neurobiology of Epilepsy group is to use analysis, data, and computational power to reveal the neural mechanisms that cause epilepsy. Genetic engineering, seizure threshold analysis, EEG analysis, quantitative morphology, physiology and computation are all combined to achieve this goal.
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