Epilepsy: key points

• Mortality data show there were 135 deaths due to epilepsy in 2023.
• Over the last 15 years, there has generally been a slight downward trend in new cases of epilepsy, identified using hospital admissions data and death records. In 2023/24, incidence increased to 31.4 admissions per 100,000 in males, while in females, incidence was stable at 22.5 admissions per 100,000.
• Males continue to have a higher incidence of epilepsy than females.

Epilepsy: introduction

Epilepsy is a common condition affecting the brain and causing frequent seizures. It is a significant cause of morbidity and mortality in Scotland. The World Health Organisation (WHO) describes epilepsy as "a chronic disorder characterised by recurrent seizures, which may vary from a brief lapse of attention or muscle jerks, to severe and prolonged convulsions. The seizures are caused by sudden, usually brief, excessive electrical discharges in a group of brain cells (neurones)."

There are over 40 different seizure types and epilepsy syndromes. Some affect only part of the brain (partial seizures) while others affect the whole brain (generalised seizures). Seizures associated with epilepsy affect people in many different ways, however symptoms may include uncontrollable jerking or shaking (a fit), loss of awareness or staring blankly, unusual smells and tastes, becoming suddenly stiff, tingling sensations in the arms and legs, or loss of consciousness. A single seizure may occur as a part of various diseases, but epilepsy is defined as having repeated seizures.

Epilepsy affects many people in Scotland, can cause major disruption to people's lives and increases the risk of death. In addition to the physical effects, there may be psychological and social effects, including cognitive, behavioural and learning difficulties, as well as social stigma. For the majority of those with epilepsy the condition can be controlled effectively with appropriate medication, and treatment usually leads to eventual remission. However in a significant minority the seizures remain difficult to control completely.

Epilepsy: risk factors

What are the risk factors for epilepsy - the underlying causes of the condition?

In most cases, the condition is described as "idiopathic epilepsy", meaning that the cause of epilepsy is not fully understood. It is thought that attacks are caused by abnormalities in neurotransmitters, which are chemicals that regulate electrical impulses in the brain. Part of the cause may be genetic, and in some rare cases the exact gene defect is well understood.

Sometimes epilepsy is caused by a specific illness or problem relating to the brain. This kind of epilepsy is termed "symptomatic" and is more common in older people. Examples of health problems that may cause this kind of epilepsy include:

• Developmental problems that started in childhood
• Head injury
• Stroke
• Brain tumours
• Encephalitis (inflammation of the brain)
• Chronic alcohol abuse