A few words about epilepsies and their complexities
- The epilepsies are a group of heterogenous disorders across all ages, where epileptic seizures are the presenting symptom and have an impact on neurodevelopment, quality of life and mortality. They affect at least 6 million people in Europe; 65% individuals will respond to antiseizure drugs or enter spontaneous remission in their lifetime. Of the remaining two million, one third could benefit from a well conducted pre-surgical evaluation and epilepsy surgery. In addition, a significant number will have presented with a distinctive rare epilepsy syndrome/disease for which the prognosis for control of seizures and neurodevelopmental outcome is extremely poor. Rare epilepsies affect nearly 5 people in 10,000 of the general population.
- Epilepsy is not viewed anymore as “a single disease”. With careful observation and description of the clinical manifestations (seizures) combined to an optimal use of diagnostic tools such as video-electroencephalography, advanced neurodiagnostics including high resolution MRI, next generation sequencing in genetics and advanced metabolic diagnostics, an increasing number of individual diseases and syndromes have emerged.
- Epilepsy can have its onset at all ages, from the newborn to the elderly, and has different aetiologies, symptoms, and outcomes that have been recognised over recent decades. We are now aware of in excess of 130 diseases recognised by a clear clinical presentation with or without clear aetiology. Early screening and, whenever possible, early diagnosis and the choice of the most appropriate treatments (medical or surgical) are of utmost importance.