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German Epilepsy Museum, Kork Oberdorfstrasse 8, D-77694 Kehl-Kork, Germany open Sundays 2.00-5.00 p.m. or by arrangement - free entrance postal address: Hornisgrindestrasse 70, D-77652 Offenburg, Germany Tel. & Fax: +49-1212-510.955.935 E-mail: info@epilepsiemuseum.de |
Introduction |
What is epilepsy? |
Epileptic seizures |
Types of epilepsies |
Causes of epilepsy |
Therapy |
Consequences |
History |
The History of Epileptology |
The Disease with 1000 Names |
Institutions for people with epilepsy |
People with epilepsy in the Third Reich |
Diagnosis |
... in the Ancient World |
modern Methods |
Therapy |
... in the Ancient World |
... in the Middle Ages |
... from the Renaissance to the Present |
Art |
Votive tablets |
Religious Art |
Other works |
Epilepsy Motifs in literature |
Famous People |
Introduction |
Gallery |
Note |
What is epilepsy? (1/2)
Hardly any other illness can be traced back in medical history as far as epilepsy can. Many pointers from early history indicate that this condition has been part of the human lot from the very beginning. Then as now, it is one of the most common chronic diseases that there are: 0.5% of all human beings suffer from epilepsy, which means that in the U.K. alone around 300 000 to 600 000 people are affected. |
The term "epilepsy" is derived from the Greek word "epilambanein", which means "to seize upon", "to attack". Thus epilepsy is a seizure or rather a disease which causes seizures to occur. As, however, there are many very different types of seizure, it is better to speak of epilepsies. ![]() ›› epileptic girl having a tonic seizure (Votive tablet from 1766) |
What is epilepsy? (2/2)
How can epilepsy be defined? When someone repeatedly has epileptic seizures then we say that that person is suffering from epilepsy. |
This pathological process takes place when suddenly an unnaturally large number of nerve cells are stimulated simultaneously, causing a difference in voltage between the outer side of the cell wall and the inside of the cell (membrane potential). This voltage difference is then suddenly discharged, creating a kind of "storm in the brain", or, to put it another way, "making a fuse blow".
If a person has one epileptic fit, it does not mean that he or she has epilepsy. Only when that person suffers repeated spontaneous epileptic seizures (i.e. without any direct trigger), should they be diagnosed as having epilepsy. Epilepsy is therefore always a chronic illness which can go on for many years (but which does not necessarily last a lifetime!). |
Epileptic seizures (1/4)
Epileptic seizures can look very different. There is hardly any function of the brain which cannot also be part of an epileptic seizure. |
These manifestations often occur in combination, for instance stiffening, jerking, salivation, wetting oneself and loss of consciousness are symptoms of a "major seizure", a "grand mal" ("great evil"). |
Epileptic seizures (2/4)
In the past, people differentiated between such "major" seizures and "lesser", "petit mal" attacks, which manifest themselves in a short clouding of the consciousness or absence) which only lasts for a few seconds, in a single jerk (myoclonia) or in a so-called twilight state. These seizures, which are also termed psycho-motor or partial complex seizures, are characterised by a twilight state lasting between 30 seconds and 3 minutes, during which the patient is confused, displays inappropriate behaviour (e.g. chewing movements, fiddling with the hands, running away) and sometimes utters intelligible but meaningless words, or incomprehensible sounds. |
The salaam spasm is a special form of petit mal seizure which occurs almost exclusively in infants and which is generally a pointer for a severe type of epilepsy. (The "salaam seizure" is so called because of the nature of the seizure, during which the patient suddenly jerks, nods or slowly bends forward, as if to make an oriental greeting.) |
Epileptic seizures (3/4)
Today specialists no longer speak of "grand mal" and "petit mal" seizures, but "generalised" and "focal" seizures. |
Epileptic seizures (4/4)
The above-mentioned grand mal seizures, absences and salaam seizures are all generalised seizures. |
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Types of epilepsies (1/2)
If a person suffers one epileptic seizure, it does not necessarily mean that he or she has epilepsy. In such cases, the seizure is linked to a certain situation and provoked by certain circumstances and is therefore known as an occasional convulsion. |
However, as an attack of fever does not trigger an epileptic seizure in every infant, and excessive alcohol consumption does not bring on a convulsion in every adolescent, the person who suffers an attack in such circumstances must also have a certain tendency or predisposition to epileptic seizures. |
Types of epilepsies (2/2)
Only when epileptic seizures occur repeatedly and spontaneously, without any clear trigger, can epilepsy be given as a diagnosis. There are many very different types of epilepsy. They are primarily characterised by the outward symptoms of the epileptic seizures, but also by the cause, the course of the disease, its prognosis (the probable outcome of the disease) and by the EEG findings (EEG: electroencephalography). All these factors can vary greatly depending on the type of epilepsy. |
The types of epilepsy are also differentiated into generalised and focal forms, depending on whether they cause generalised or focal seizures. |
Causes of epilepsy (1/2)
There are many different causes of the various types of epilepsies. Most epilepsies are residual epilepsies, which means that the epilepsies are the "remains" of a cerebral disorder which occurred in the past. |
Process epilepsy is a type of epilepsy caused by a progressive cerebral disease which is still active. |
Causes of epilepsy (2/2)
Epilepsies are not hereditary diseases, they cannot be passed on from one generation to the next. |
Such a type of epilepsy, which is mainly caused by genetic disposition is known as a idiopathic epilepsy. In around one third of all epilepsies, the cause of the disease remains unknown. |
Therapy (1/2)
Today, there are very good methods available for treating of epilepsy. Certain types of epilepsy are curable.
Before beginning treatment, the patient has to be examined to ascertain whether the cause of the epilepsy can be removed. |
In most cases, however, this is not possible, either because no cause for the disease can be found, or because it cannot be removed (e.g. a scar in the brain, an anomaly in the brain, or predisposition). The treatment of these types of epilepsies is known as symptomatic therapy. |
Therapy (2/2)
The "classic" symptomatic therapy, used in over 90% of all cases of epilepsy, is the administration of anti-epileptic drugs, which generally have to be taken over several years. |
Out of 10 patients treated with drugs ... ![]() ... 6 become seizure free ![]() ... 2 show considerable improvement ![]() ... 2 show no improvement
In some cases, patients can be successfully treated using epilepsy surgery. However, this is only possible with focal epilepsies and can only be considered as an option in 5% of all patients.
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Consequences (1/2)
Epileptic seizures only cause a temporary disorder of certain cerebral functions, but they do not usually cause permanent brain damage. The widely held opinion that epileptic seizures inevitably lead to a continuous decline of certain cerebral functions (e.g. intelligence) is, therefore, ungrounded. This is not true of the so-called status epilepticus, however. This state is an unusually long grand mal seizure, which can go on for 10 minutes or more, and even last for hours! |
During such a "status" the brain cells can become permanently damaged Fortunately such grand mal states occur very rarely today thanks to modern drug therapy. If epileptic patients have mental abnormalities, e.g. mental retardation, behavioural or speech disorders, these are not usually caused by the epilepsy but by the brain disorder which itself is the cause of the epilepsy. |
Consequences (2/2)
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This is a very important factor in the care of epileptic patients. |