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The word epilepsy comes from the verb “epilepsia”, meaning to be possessed by some supernatural force. Historically, the Babylonians mentioned it around 3000 BC as an invasion of the body by demons, while the Ancient Greeks also believed that it had a divine origin and called it a “sacred disease”. Hippocrates was the first to express the belief that it was not a disease of divine origin in his text “On the Sacred Mind”, and he mentioned for the first time the possibility of the brain being involved.

Epilepsy, therefore, is a brain disorder characterized by a persistent predisposition to produce epileptic seizures, as well as by the neurobiological, cognitive, psychological and social consequences that this entails (International League Against Epilepsy-ILAE, 2005).

Epilepsy occurs in 1-2% of the general population, with a maximum incidence in children under 2 years of age and in the elderly. The incidence increases in special populations, with underlying diseases such as in the case of individuals with neurodevelopmental disorders, e.g. autism spectrum disorder (ASD) (~10%) and in patients with cerebral palsy (~30%).

As stated in the article Practical Definition of Epilepsy, 2014, in order to make a diagnosis of epilepsy, there must be at least 2 unprovoked episodes of seizures that have occurred more than 24 hours apart, or one episode of unprovoked seizures but with the possibility of recurrence (over 60%), due to specific conditions and finally in the case of a diagnosis of epileptic syndrome.

Epilepsy, depending on the etiology, is distinguished into symptomatic or idiopathic. In symptomatic epilepsy, there is a known underlying cause, which has caused damage to the brain, such as in cases of prematurity and cerebral palsy, metabolic diseases, in the case of an ischemic episode, but also in cases of abnormal development of brain structures due to genetic diseases.

Idiopathic epilepsy refers to cases without a known cause, with normal neuroimaging. Benign epileptic syndromes (epilepsy with centroparietal spikes, Panayiotopoulos syndrome) belong to this category. The severity of epilepsy and the general condition of the child depend on the etiology of the disease, with 80% of childhood epilepsies having a good outcome.

An epileptic seizure can be focal, involving one hemisphere and by extension one half of the body/face, which may not be accompanied by loss of consciousness, but also generalized, involving both hemispheres, with loss of consciousness and motor phenomena of the trunk and limbs.

The diagnosis should include an electroencephalogram (EEG), with sleep deprivation. The EEG is a simple test that uses electrodes that are placed on the scalp in a specific position in order to study the electrical activity of the brain. Recording sleep is important and should be included in the EEG test.

The information that the EEG gives us, if pathological, is related to the type of seizures, focal or generalized, the possibility of recurrence and the need for neuroimaging, with brain MRI. With the above information, a treatment and monitoring plan for the patient will be drawn up, which may concern the initiation of antiepileptic treatment.

Treatment consists of the use of one or a combination of antiepileptic drugs that suppress/control brain function with the aim of controlling the episodes. In the event that the episode lasts more than 3 minutes, rescue medication should be administered, as there is a risk of transition to status epilepticus (epileptic state), a condition that requires immediate treatment in a hospital environment.

Drug resistance can occur in up to 1/3 of patients. In addition to the use of drugs, the treatment of epilepsy has been extended to special diets (ketogenic diet), to special surgical procedures (vagal stimulator), but also to epilepsy surgery.

In recent years, the etiology of epilepsy has been investigated extensively and genetic loci and genes responsible for its occurrence have been found. This development has helped in targeted treatment.

Information, support and education are very important, both at the cognitive and psychological level of patients, their families, the school context and society as a whole in dealing with and managing the problems that arise in patients with epilepsy.