A Deep Dive into Epilepsy and it’s (Not-So) Shocking Ramifications on Global Health


Epilepsy is a neurological condition characterized by a recurrent onset of seizures (Mayo Clinic, 2021). Seizures are abnormal electrical activity in the brain which can be divided into two categories: focal and generalized. Focal seizures originate from one area of the brain, whereas a generalized seizure involves all areas. Seizures are often short-lived events, lasting 30 seconds to two minutes; however, they may classify as a medical emergency if prolonged for a longer duration (Mayo Clinic, 2021). Because seizures may affect any location of the brain, symptoms vary considerably, ranging from temporary loss of awareness to physical twitches or disturbances in sensations. Not all seizures can be classified under epilepsy. As at least two unprovoked seizures, within a 24-hour timeframe, are usually needed for a complete diagnosis (Mayo Clinic, 2021). As individuals with epilepsy may experience seizures at a higher frequency, they consequently may experience more severe symptoms such as muscle spasms, injuries, behavioral changes, or psychological conditions such as anxiety. 

The causes and mechanism of action for epilepsy are widely unknown for about 50% of all cases (World Health Organization, 2022). Epilepsy can result from genetic, structural (physical abnormality/ injury), infectious, or immune causes. Some examples include oxygen deprivation during one’s prenatal stage, stroke, genetic conditions relating to brain malformations, or head trauma (World Health Organization, 2022). While treating the underlying cause of epilepsy is generally not feasible, treating the symptoms of seizures is largely an attainable goal for many patients. Medications, such as antiepileptic drugs (AEDs), are considered initial options for treatment plans because they treat seizures by reducing excessive electrical signals sent by neural cells (American Association of Neurological Surgeons, 2021). With numerous AEDs available on the market, individuals have more options to choose the right medication for them based on their physical and social needs. Treatment plans may also include prescribed diet modifications, such as a ketogenic diet, for children who do not benefit from medications (American Association of Neurological Surgeons, 2021). A ketogenic diet is high in fats and low in carbohydrates, which are believed to reduce glutamate concentrations in the brain and increase gamma-Aminobutyric acid (GABA) synthesis. These are excitatory and inhibitory neurotransmitters respectively which result in reduced electrical signaling between neighboring neural cells (Wnuk, 2018). While surgery is considered a final option for treatment, some individuals with epilepsy may greatly benefit from surgical options if they respond poorly to AEDs (American Association of Neurological Surgeons, 2021). 

With the increasing treatment options, epilepsy is increasingly becoming a manageable condition for most. Of patients with recorded epilepsy, 70% report no seizures largely due to the help of AEDs. When considering epilepsy and its effects, one must consider the global context for the condition as the rate of incidence falls higher in low and middle-income countries. Of all individuals with epilepsy, 80% reside in such countries where preventable health and accessible care are likely to be lacking (World Health Organization, 2022). Therefore, individuals in low and middle-income countries are more susceptible to an increased risk of infectious conditions or birth-related injuries. Further, treatment barriers exist for around 75% of these individuals where they do not have access to medications (World Health Organization, 2022). Thus, it is crucial to see the varying support levels provided to low and middle-income countries to assist in this global health issue which inevitably pushes individuals towards a greater inequitable fate. 

 

References

American Association of Neurological Surgeons. (2021). Epilepsy. https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Epilepsy

Mayo Clinic. (2021, February 24). Seizures. https://www.mayoclinic.org/diseases-conditions/seizure/symptoms-causes/syc-20365711

Mayo Clinic. (2021, October 7). Epilepsy. https://www.mayoclinic.org/diseases-conditions/epilepsy/symptoms-causes/syc-20350093

Wnuk, A. (2018, August 14). How Do Ketogenic Diets Help People With Epilepsy? BrainFacts. http://www.brainfacts.org/diseases-and-disorders/epilepsy/2018/how-do-ketogenic-diets-help-people-with-epilepsy-081418

World Health Organization. (2022, February 9). Epilepsy. https://www.who.int/news-room/fact-sheets/detail/epilepsy

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