It is estimated that worldwide there are 50 million people diagnosed with epilepsy. In Portugal, there are between 40,000 and 70,000, which is equivalent to about one patient in every 200. Stigma is one of the biggest barriers faced by individuals living with this chronic neurological condition and "is as or more harmful than the disease itself," Rute Teotónio, a neurologist and neurophysiologist at the Refractory Epilepsy Center of the Coimbra University Hospital and University Center, told Lifestyle ao Minuto, warning of the "very significant impact on the quality of life and well-being of patients and their families." The doctor also states that epilepsy does not affect the intellectual capacity of those who suffer from it. "About two-thirds of patients with epilepsy do not have any seizures when taking medication. In fact, contrary to what is sometimes thought, the vast majority of people with epilepsy do not have an intellectual deficit."

© Rute Teotónio

What is epilepsy? 

It is a chronic neurological disease that is characterized by the brain's predisposition to the occurrence of recurrent and unprovoked epileptic seizures, which occur suddenly and unpredictably. They are due to abnormally excessive discharges involving part or all of the brain. These seizures are usually short-lived and manifest themselves with different characteristics from person to person. 

Fortunately, about 60 to 70% of patients have their seizures well controlled by taking regular medication, and can have a so-called 'normal' lifestyle, without major restrictions

Is it a serious disease?

Its severity is variable and depends primarily on three aspects which, although distinct, are often associated: the etiology of epilepsy, the type and frequency of epileptic seizures. Usually, epileptic seizures are self-limited paroxysmal phenomena of short duration that occur unpredictably. The severity that results from them is essentially due to possible falls or other accidents caused by the presence of involuntary movements or by the disturbance of consciousness that occurred during the episode. Fortunately, about 60 to 70% of patients have their seizures well controlled by taking regular medication, and can have a so-called 'normal' lifestyle, without major restrictions.

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What is the prevalence of epilepsy in the world and in Portugal?

In Portugal, it is estimated that there are about 40,000 to 70,000 people with Epilepsy, which is equivalent to one person in every 200. Each year, about 50 new patients emerge per 100,000 people. About 50 million people worldwide suffer from Epilepsy. In Europe, there are six million people with epilepsy.

Who is most affected?

Epilepsy does not choose gender, age, ethnicity or social class. It can occur in anyone and at any age. There is no difference in prevalence between the sexes. We know, however, that the incidence is higher in the first year of life and after 60 years of age.

Why does epilepsy develop?

Epileptic seizures result from abnormally excessive electrical brain activity involving part or all of the brain. Patients have a loss of normal regulatory mechanisms that ensure the proper balance between inhibition and neuronal hyperexcitability. At the base of the loss of this balance may be structural causes - a head injury, for example -, genetic, infectious, metabolic and autoimmune.

Are there different types of epileptic seizures?  

Yes. It all depends on the brain areas involved, and it varies from person to person. The manifestations can be quite subtle, only subjective and imperceptible to others. They can involve transient sensory or sensory changes, such as tingling or perception of odors that are not real. On the other hand, we may have episodes in which there is an alteration in the state of consciousness and responsiveness, as if they were brief lapses of attention or memory. Sometimes seizures can be clinically more conspicuous, characterized by the presence of involuntary movements of part or all of the body.

What is the most common type of epilepsy? 

The most frequent form of epilepsy is the so-called focal, that is, the one that starts in a relatively restricted area of the brain, and may or may not extend to other regions later.

How is the diagnosis made?

It is essentially clinical and is based on the description that the patient or witnesses make of the seizures. For this reason, it is extremely important that, whenever possible, the patient be accompanied to the medical consultation by people who have already witnessed the events. Mobile phones also offer us today the possibility of recording various moments of our daily lives, also constituting a potential added value when the doctor seeks to understand the nature of the episodes described.

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In most cases, the diagnosis of epilepsy requires lifelong treatment

What factors help control epilepsy?

The main one is surely the regular and adequate intake of medication. There are also other precautions related to lifestyle, namely the presence of good sleep hygiene with avoidance of sleep deprivation or excessive alcohol intake.

Is the treatment for life?

The duration of treatment will depend on the type of epilepsy. Some epilepsies, which usually appear during childhood, can be self-limited and end up resolving with age. However, in most cases, the diagnosis of epilepsy requires lifelong treatment. 

Have there been advances in the treatment of epilepsy? 

One of the aspects with the greatest impact on the quality of life of people with epilepsy has been the development in the therapeutic area, with the appearance of new drugs and the possibility of a surgical approach in some epilepsies. However, much remains to be done. But patients who have managed to control their seizures after the introduction of a new medication or by surgery are the reason why it is worth supporting research, investing in resources and improving the healthcare network.

How does this disease impact the patient's