Epilepsy

Across Africa, epilepsy remains one of the most common neurological disorders, yet it is often misunderstood and stigmatized. The World Health Organization estimates that nearly 10 million people on the continent live with epilepsy, with rural areas experiencing a treatment gap of up to 75%. In cities like Nairobi and Lagos, healthcare access is improving, but many patients still go years without a proper diagnosis or effective treatment. This condition is not only a health challenge it is a social and economic one too.

What is epilepsy?

Epilepsy is a chronic neurological condition where the brain produces repeated, unprovoked seizures. These seizures occur because of sudden bursts of abnormal electrical activity in the brain, disrupting normal communication between nerve cells. Unlike a single seizure that may result from illness, fever, or injury, epilepsy is defined by a pattern of recurrent events.

Who does epilepsy affect?

Epilepsy can affect anyone. Children, adults, and older adults all face the possibility of developing it, although the risk peaks in early childhood and again after the age of 60. In Africa, younger populations are more commonly affected due to higher rates of infections, birth complications, and head trauma.

How common is epilepsy?

Globally, about 50 million people live with epilepsy, making it one of the most widespread neurological conditions. In Sub-Saharan Africa, the prevalence is higher than in most other regions, partly because of limited access to healthcare services, late treatment, and preventable causes like untreated infections.

What happens in your brain when you have epilepsy?

When you have epilepsy, groups of neurons in the brain send out chaotic bursts of electrical signals. These signals overwhelm the brain’s normal rhythm, leading to seizures. Depending on which part of the brain is affected, a seizure may cause changes in movement, sensation, behavior, or even consciousness.

What are the types of epilepsies and their seizure symptoms?

Seizures vary widely, and doctors classify them into two main groups:

Focal onset seizures

These start in a specific area of the brain. They may affect movement, emotions, or the senses, sometimes without loss of awareness. A person may suddenly feel fear, taste something metallic, or experience jerking in one part of the body.

Generalized onset seizures

These involve networks on both sides of the brain from the start. They can cause loss of consciousness, convulsions, or sudden stiffening. Tonic-clonic seizures, the type most people think of when they hear “epilepsy,” fall into this category.

What are seizure triggers?

Seizures often have triggers situations or factors that increase the likelihood of an episode. Common triggers include lack of sleep, stress, flashing lights, alcohol use, or missed medications.

How can I figure out my seizure triggers?

The most effective way is to keep a seizure diary. Recording what happens before, during, and after a seizure helps identify patterns. Over time, you and your healthcare provider can use this record to develop strategies that reduce risk.

Symptoms and Causes

What are the signs and symptoms of epileptic seizures?

Symptoms vary widely depending on seizure type. They may include temporary confusion, staring spells, uncontrollable movements, loss of awareness, or emotional disturbances. Some people experience an “aura” before a seizure, such as unusual smells, sounds, or feelings.

What causes epilepsy?

Causes are diverse. Infections of the brain, head injuries, genetic factors, developmental disorders, and stroke are all linked to epilepsy. In many cases, no clear cause can be identified. In parts of Africa, preventable causes such as meningitis, malaria, and birth trauma play a significant role.

Diagnosis and Tests

How is epilepsy diagnosed?

Diagnosis begins with a detailed medical history, including descriptions of seizures from patients and witnesses. A neurologist may then recommend tests to confirm the condition and rule out other causes.

What tests will be done to diagnose this condition?

Common tests include an EEG (electroencephalogram) to detect abnormal brain activity, MRI or CT scans to look for structural problems, and blood tests to rule out metabolic issues. Sometimes video EEG monitoring is used to capture seizure activity as it happens.

Management and Treatment

How is epilepsy treated?

Treatment depends on the type of seizures, their severity, and the patient’s overall health. While epilepsy cannot always be cured, it can often be controlled effectively.

Anti-seizure medications

Medications are the first line of treatment. Many people achieve good seizure control with the right drug, but finding the correct medication and dose may take time.

Diet therapy

Special diets, such as the ketogenic diet, can help reduce seizures, particularly in children whose seizures are resistant to medication.

Surgery and devices

For people who do not respond to medications, surgery may be an option. Surgeons can remove the brain area causing seizures. Devices like vagus nerve stimulators are also available in some regions to help control seizures.

Outlook / Prognosis

Is there a cure for epilepsy?

There is no universal cure, but treatment can often control seizures so effectively that many people live seizure-free for years.

Will I always have seizures?

Not necessarily. With treatment, more than half of people with epilepsy eventually achieve long-term remission.

How long will I have to take anti-epileptic medications?

This depends on the individual. Some may take medication for life, while others may safely stop after years without seizures. Decisions should always be made with a healthcare provider.

Prevention

Can epilepsy be prevented?

Not all cases can be prevented. However, reducing risk factors such as preventing head injuries, treating infections promptly, and ensuring safe childbirth can lower the chances of developing epilepsy.

Living With

When should I see my doctor? When should I go to the emergency room?

You should consult your doctor if seizures are new, changing in pattern, or difficult to control. Emergency care is required if a seizure lasts longer than five minutes, if seizures occur back-to-back, or if recovery is slow.

How can I manage my seizures?

Consistent use of medication, identifying and avoiding triggers, and maintaining a healthy lifestyle are key. Regular follow-ups with healthcare providers are essential to adjust treatment as needed.

Can I drive if I’ve been diagnosed with epilepsy?

Driving regulations vary by country, but most require a person to be seizure-free for a certain period before being allowed to drive. It is important to check local laws and always prioritize safety.

What are the life-threatening complications of epilepsy?

Status epilepticus

A medical emergency where seizures last longer than five minutes or occur without recovery in between. Without immediate treatment, it can cause brain damage or death.

Sudden unexplained death in epilepsy (SUDEP)

A rare but serious risk where a person with epilepsy dies suddenly without a clear cause. The risk is higher in those with frequent, uncontrolled tonic-clonic seizures.

Additional Common Questions

What’s the difference between convulsions, seizures and epilepsy?

A seizure is an event caused by abnormal brain activity. Convulsions are the physical shaking movements that may accompany some seizures. Epilepsy is the chronic condition that leads to repeated, unprovoked seizures.

Published 11th Sept 2025

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