Silent but deadly

Epilepsy is the second most common neurological condition after migraine, with more than 400,000 people in the UK having the condition. In the past little was understood about epilepsy and those who had the condition faced prejudice through fear or lack of knowledge. However, attitudes are now changing and although living with epilepsy can cause its problems, most people can lead active, healthy, satisfying lives.

Epilepsy is characterised by seizures (previously known as fits) caused by a temporary change in the way our brain cells work. The brain is like a computer consisting of a vast network of brain cells called neurons. Throughout our lives billions of electrical messages are passed between these cells, controlling every single thing we think, feel or do.

A sudden uncontrolled episode of electro-chemical activity in the brain can cause these electrical messages to become scrambled and temporarily disrupt communication between the neurons, causing an epileptic seizure.

There are over 40 different types of seizure, which are either generalised seizures or partial seizures.

Generalised seizures start in both sides of the brain at the same time. There are several types, including tonic-clonic (grand-mal) where a person becomes unconscious, absence (petit-mal) where a person may appear to be just 'day dreaming' for a short while and myoclonic (sudden jerks). What a person experiences and what others see depends on where the seizure starts and how quickly the scrambled messages spread through the brain.

In partial seizures the person remains conscious and the form depends on where in the brain the disruption starts. Different types could be the jerking of an arm, experiencing feelings of fear, or unpleasant tastes or smells. In complex partial seizures consciousness becomes disturbed and the person may be unaware of what they are doing. During this period repetitive movements can occur such as fiddling with clothing. Afterwards the person is confused for a few minutes.

Any time, any place

Epilepsy can affect any of us, at any age. Although it can affect both sexes, males are more prone to the condition than females, though the reason for this is not known. Also, more people develop the condition either during childhood or adolescence, or over the age of 60.

Sometimes the specific reason for epilepsy developing is obvious. This may be referred to as symptomatic epilepsy with a variety of possible causes, which include:

• Head injury or a severe blow to the head.

• Serious infections such as encephalitis, meningitis, and other infections where the body temperature is very high (over 90ºC).

• Other brain conditions such as stroke, aneurysms and embolisms.

• Growths or tumours in the head.

• Chronic conditions such as cerebral palsy.

• Alcohol abuse over a long period of time can bring on a seizure after drinking or during a period of withdrawal.

In six out of 10 cases, people with epilepsy are perfectly healthy, and no underlying disease can be found that would cause them to have seizures. This is known as idiopathic epilepsy.

Epilepsy is not in any way linked with mental illness or learning difficulties. In fact Leonardo da Vinci, Agatha Christie, Elton John and Max Clifford are some of the names appearing on the list of many famous people who have the condition.

Epilepsy also carries risks and there are around 1,000 deaths each year in the UK as a result of epilepsy.

Around 500 people with epilepsy die in the UK each year from an accident that occurs as a result of a seizure, or from a condition known as 'status epilepticus' where one seizure follows another without the person regaining consciousness.

Another 500 people with epilepsy die from a little known syndrome called Sudden Death in Epilepsy (SUDEP). In SUDEP no specific cause of death is found and research to date indicates deaths of this nature typically occur in healthy, young adults, particularly male, who experience tonic-clonic (grand-mal) seizures.

However, most people with epilepsy whose seizures are well controlled are not at risk of dying from epilepsy.

There is no known cure for epilepsy, but there are drugs which allow many people to live life virtually seizure-free. Some drugs work by making over-active brain cells less excitable, while others decrease the brain cells' ability to transmit abnormal impulses to each other. Alternative therapies such as homeopathy, herbalism, bio-feedback and aromatherapy are known to be helpful.

Surgery is carried out in a small number of cases where seizures are particularly severe and the condition is difficult to control by medication alone although the majority of cases are treatable by anti-epileptic drugs.

For a normal car licence, a person with epilepsy cannot drive for one year after having an epileptic seizure. For a LGV/PSV licence, a person can only drive if they have not had a seizure for at least 10 years while having no treatment. Driving is not allowed while treatment is being withdrawn, or for six months afterwards, and if another seizure occurs during this period, the usual rules apply.

Sandra Wood is a life and disability underwriter at Scottish Equitable Protect

Epilepsy: the statistics

• Epilepsy is the tendency to have recurrent seizures.

• There are over 40 different types of seizure and a person may have more than one type.

• Epilepsy can affect anyone, at any age and from any walk of life.

• 440,000, or one in every 133, people in the UK have epilepsy.

• On average 81 people every day are diagnosed with epilepsy.

• Around 75% of people with epilepsy in the UK have their seizures well controlled by medication.

• One in 20 people will have a single seizure at some time in their life.

• Many people who develop epilepsy below the age of 20 will 'grow out of it' in adult life.

• Many people with epilepsy are still discriminated against due to ignorance about the condition.

• Epilepsy is covered by the UK's Disability Discrimination Act.