Epilepsy

What is Epilepsy?

Epilepsy is a long-termneurological disorder that causes repeated seizures, episodes of abnormal electrical activity in the brain. Seizures can cause involuntary movements, unusual sensations, changes in emotions or behaviour, and sometimes a brief loss of consciousness. Some people have seizures rarely, while others may have them several times a day. Because epilepsy can look very different from person to person, it is sometimes called the epilepsies".It is important to know that having one seizure does not necessarily mean that a person has epilepsy. Instead, epilepsy is mainly defined as the occurrence of two or more unprovoked seizures.

What are the Types of Epilepsy?

Epilepsy is seen in many different forms, often referred to as epilepsy syndromes. Here are some of the most commonly identified types:

How Common is Epilepsy in India?

Epilepsy is one of the most common neurological conditions in India, affecting more than 15 million people, making it one of the largest populations living with the condition in the world. A significant concern is that drug-resistant epilepsy, where patients do not respond well to standard anti-seizure medications, affects approximately 20% to 30% of all epilepsy patients in the country.

Epilepsy is also common among children and teenagers in India. A study published in the Seizure Journal in 2025 found that the highest rates were in the Northeast, while Central India had the lowest.

Symptoms of Epilepsy

The symptoms of epileptic seizures depend on the region of the brain where abnormal electrical activity originates and how it propagates. Consequently, symptoms can differ considerably between individuals.

When to See a Healthcare Provider?

Call emergency services if:

• A seizure lasts longer than 5 minutes

• Another seizure begins soon after the first one ends

• The person has difficulty breathing or cannot be woken after the seizure

• The seizure happens in water

• The person is injured, pregnant, or has a health condition such as diabetes or heart disease

Related Diseases Comparison

Epilepsy can be difficult to distinguish from other conditions that cause sudden alterations in awareness or movement. Accurate diagnosis is essential, as effective treatment depends on identifying the underlying cause.

Epilepsy vs Syncope vs Psychogenic Nonepileptic Seizures

Medicines Used to Treat Epilepsy

Although epilepsy is not curable, it can often be well controlled. With appropriate medication, up to 70% of individuals with epilepsy may achieve seizure control.

• Standard antiseizure medicines, such as carbamazepine, phenobarbital, phenytoin, and valproic acid

• Medicines used for focal or partial seizures, including carbamazepine, valproate, phenytoin, lamotrigine, clobazam, and phenobarbitone

• Medicines used for generalised tonic-clonic or clonic seizures, such as valproate, perampanel, carbamazepine, lamotrigine, clobazam, and phenobarbitone

• Absence-seizure medicines, including valproate, ethosuximide, lamotrigine, clonazepam, and acetazolamide

• Newer antiseizure medicines for patients not benefiting from older medicines, such as gabapentin, levetiracetam, oxcarbazepine, tiagabine, topiramate, and vigabatrin

• Benzodiazepines, including clobazam and clonazepam

Living with Epilepsy in India: Daily Challenges, Financial Considerations, and Caregiver Support

Living with epilepsy presents practical, financial, and emotional challenges. However, with appropriate treatment, care and support, many individuals are able to achieve seizure control and experience an improved quality of life.

Epilepsy Treatment Cost in India

Epilepsy treatment is usually long-term, and epilepsy treatment costs may increase with repeated doctor visits, multiple medications, hospitalisations, or the need for surgical evaluations.

Disclaimer: The numbers cited above are example costs and may change depending on the city, doctor, and your treatment plan.

What Causes Epilepsy?

Epilepsy occurs when the brain's electrical signals do not get released in an organised way. Instead of sending signals in a controlled manner, large groups of brain cells send them all at once or much faster than they should, causing a sudden burst of electrical activity that triggers a seizure.

Known causes are broadly grouped into the following categories:

• Structural: Physical damage to the brain, such as that caused by a serious head injury, stroke, brain tumour, bleeding in the brain, or growth abnormalities, can disrupt normal electrical activity and lead to epilepsy.

• Genetic: Changes or mutations in genes that affect how brain cells communicate can cause epilepsy. Some genetic forms of epilepsy run in families, while others occur as new gene changes with no family history.

• Infectious: Brain infections such as meningitis, encephalitis, and neurocysticercosis, as well as certain viral infections, including HIV, can cause epilepsy.

• Metabolic: Rare imbalances in the body's chemicals that affect brain function can trigger epilepsy in some individuals.

• Immune: Autoimmune conditions that cause inflammation in the brain, such as autoimmune encephalitis, can interfere with normal brain activity and lead to seizures.

• Prenatal and Perinatal Causes: Brain damage occurring before or during birth, such as oxygen deprivation during delivery or low birth weight, can increase the risk of developing epilepsy later in life.

Risk Factors of Epilepsy

Epilepsy can develop in anyone, but the following things can raise the chances of having the condition.

• Age: Epilepsy is most typically seen in children and older adults, though it can develop at any age.

• Family History: Having a close biological relative who has epilepsy increases the possibility of developing the condition.

• Head Injuries: Traumatic brain injuries are a known cause of epilepsy. Wearing a seatbelt in vehicles and a helmet during high-risk activities can help reduce this risk.

• Stroke and Vascular Disease: Stroke and other blood vessel diseases can cause brain damage that triggers seizures.

• Brain Infections: Infections like meningitis and encephalitis can raise the risk of developing epilepsy by causing inflammation in the brain or spinal cord.

• Neurological Conditions: Conditions such as Alzheimer's disease, dementia, cerebral palsy, and brain tumours are associated with a higher risk of epilepsy.

• Prenatal and Birth-Related Factors: Premature birth, low birth weight, or oxygen deprivation during delivery can increase the risk of developing epilepsy later in life.

• Febrile Seizures in Childhood: High fevers in childhood can sometimes cause seizures. The risk is higher if the seizures are prolonged, if the child has an underlying nervous system condition, or if there is a family history of epilepsy.

• Alcohol Use Disorder: Excessive or long-term alcohol use is linked with an increased risk of seizures and epilepsy.

What are the Complications of Epilepsy?

Epilepsy can lead to various complications that go beyond the seizures themselves, affecting physical safety, mental health, and overall quality of life.

Some of the key complications include:

• Physical Injuries: Seizures can cause falls, burns, cuts, or broken bones. People with epilepsy are also at a higher risk of drowning while swimming or bathing if a seizure occurs in the water.

• Car and Road Accidents: Seizures that cause sudden loss of awareness can be dangerous while driving or operating heavy machinery. Many regions have specific regulations requiring a minimum seizure-free period before a person with epilepsy is permitted to drive.

• Sleep Problems: People with epilepsy frequently experience difficulty falling asleep or disturbed sleep cycles, which can further affect daily functioning and overall well-being.

• Cognitive Difficulties: Epilepsy can cause problems with memory, attention, learning, and following directions, particularly in those with certain types of the condition.

• Mental Health Conditions: People with epilepsy have a higher risk of developing depression, anxiety, and, in some cases, suicidal thoughts. These can be a result of living with the condition itself as well as the side effects of medication.

• Pregnancy Complications: If a pregnant woman experiences seizures, both the mother and the baby can be at risk. Certain anti-seizure medications can also increase the risk of birth defects.

• Status Epilepticus: In this condition, the patient experiences long-lasting seizures, with some lasting for more than five minutes. Some patients go through a series of seizures happening one after the other without the person regaining consciousness in between. It can cause permanent impairment to a person's brain.

• Sudden Unexpected Death in Epilepsy: This refers to a sudden death of a person with epilepsy who otherwise seemed to be healthy. The exact reasons have not been discovered, but research suggests it may be linked to heart or respiratory complications during a seizure.

When Should I See My Healthcare Provider?

If you have a seizure for the first time, call an ambulance immediately. If people around you notice that you zone out or lose consciousness for a little while, it is worth calling a healthcare provider, who may refer you to a neurologist for further testing and evaluation.

If you are with someone having a seizure, call for emergency services immediately if the seizure lasts longer than five minutes or the person has repeated seizures. The person does not regain consciousness between the seizures.

How is Epilepsy Diagnosed?

Diagnosing epilepsy involves a review of symptoms and medical history alongside a series of tests to confirm the condition and identify its cause.

How is Epilepsy Treated?

There is currently no permanent cure for epilepsy, but a range of treatments are available that can significantly reduce the frequency and severity of seizures.

• Medicines: Anti-seizure medicines are the first and most common line of treatment for epilepsy. At least half of people newly diagnosed with epilepsy become seizure-free with their first medication. There are more than 30 different types of anti-seizure medicines available.

• Surgery: When medicines do not adequately control seizures, surgery may be considered. There are multiple surgical options, such as the following:

• Resective Surgery

• MRI-Guided Laser Ablation

• Vagus Nerve Stimulation

• Deep Brain Stimulation

• Responsive Neurostimulation

• Keto Diet: For some people, particularly children, a ketogenic diet, which has high levels of fats and low levels of carbohydrates, can help reduce the frequency of seizures. The body breaks down fats rather than carbohydrates for energy, and researchers believe this creates chemical changes in the brain that help suppress seizures.

Can Epilepsy be Prevented?

Not all cases of epilepsy can be avoided, as some causes, such as genetic factors, are beyond a person's control.

However, certain steps can help lower the risk of developing the condition:

• Prevent Traumatic Brain Injury: Wearing a seatbelt while driving, ensuring children are secured in properly installed car seats, wearing a helmet during cycling or contact sports, and avoiding driving under the influence of alcohol or drugs can all reduce the risk of brain injuries that may lead to epilepsy.

• Lower Your Risk of Stroke: Because stroke can cause epilepsy, living well and making healthy choices matter. This includes eating nutritious food, staying active, managing weight, not smoking, limiting alcohol intake and managing stress effectively.

• Prevent Cysticercosis Infection: The most typical cause of epilepsy is neurocysticercosis, a parasitic infection caused by tapeworm eggs. Practising good hand hygiene, preparing food safely, and drinking treated or bottled water, particularly when travelling abroad, can help prevent this infection.

• Get Vaccinated: Staying up to date with recommended vaccines can help protect against infections that may cause seizures and lead to epilepsy.

• Manage Fevers in Children: Promptly managing high fevers in young children can help reduce the risk of febrile seizures.

What is the Prognosis of Epilepsy?

Epilepsy is a long-term condition that impacts everyone differently, and managing it is often an ongoing process. Finding the right treatment plan may take some time, and adjustments may be needed as the condition evolves. Regular follow-up with a healthcare provider is an important part of ensuring the best possible outcomes.

Beyond medication and medical care, managing epilepsy also involves looking after overall well-being. Getting enough sleep, eating well, and managing your mental health all play a meaningful role in how well the condition is managed day to day.

Does Health Insurance Cover Epilepsy?

Yes, Health insurance policies in India do not cover epilepsy directly. However, as per the newer IRDAI guidelines, indirect coverage for epilepsy may be possible through health insurance plans that cover genetic conditions, mental illnesses, and psychological disorders, which are closely related to epilepsy. The extent of coverage, and specific exclusions can vary from one policy to another, so ensure that you go through the policy wording and other documents carefully.