Ask the Doctor

Is this epilepsy?

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I have a 15-year-old relative who sometimes goes into seizures. Kindly let me know if this is epilepsy or something else.

Bidemi (by SMS)

No, not everyone who has a seizure has epilepsy. Up to 10% of people worldwide will experience at least one seizure during their lifetime, but the proportion living with active epilepsy at any given time is only 4 to 10 per 1,000.

The gap between those two numbers is enormous, and it reflects a core distinction in medicine: a seizure is a single event, while epilepsy is a pattern of recurring, unprovoked seizures. Epilepsy is generally diagnosed after a person has had two or more unprovoked seizures separated by at least 24 hours. The word “unprovoked” is doing heavy lifting here. It means the seizure wasn’t triggered by an obvious, identifiable cause like a head injury, a drug reaction, or a dangerous drop in blood sugar.

READ ALSO: Living well with epilepsy: A diagnosis is not the end of the story

The seizure happened on its own, without a clear external explanation. A large share of seizures fall into the “provoked” or “acute symptomatic” category. These are seizures triggered by a specific medical problem, and once that problem is resolved, the seizures typically stop.

Across all age groups, the most common causes are head trauma, stroke, drug or alcohol withdrawal, and infections affecting the brain. The treatment for provoked seizures focuses on fixing the underlying problem, not on long-term seizure medication.

Correcting the electrolyte imbalance, treating the infection, or managing the withdrawal is what stops the seizures. These events don’t count toward an epilepsy diagnosis because the brain isn’t generating seizures on its own.

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Tags: Epilepsy

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