What are epileptic seizures and epilepsies?

The word epilepsy comes from the Greek and means "to be seized or clutched" or "to be afflicted with something or be captured by something". In ancient times epilepsy was also referred to as "Morbus sacer" or "holy disease" which gave it special recognition that it sometimes still has today. Many people believe it is very simple to describe an epileptic seizure. Someone screams suddenly out of the blue, loses consciousness, then becomes stiff, possibly bites his tongue and collapses. He holds his breath and turns blue, has arm and leg spasms for a certain period of time, until out of exhaustion, he falls into a kind of deep sleep. Afterwards, he might complain of abnormal fatigue, headache, dizziness, or muscle aches. Sometimes it can progress to involuntary urination. It is true that this description is apt for a frequent form of epileptic seizure (the so-called grand mal seizure or generalised tonic-clonic seizure), however this type of seizure is only one of many.

Epileptic seizures can have very diverse manifestations. They can occur without screaming or loss of consciousness, without stiffening, tongue biting, and collapsing, without turning blue or having convulsions. They can be so harmless that neither the person affected realises it nor the non-expert notices anything when they directly observe a seizure. The only sign of an epileptic attack can be inattentiveness for five to ten seconds or a brief twitching of one arm.

A generally valid definition and one that is applicable to all epileptic seizure forms could be the following: Epileptic seizures are relatively brief, sudden changes in consciousness, reasoning, behaviour, memory, senses, or sensation, or the tensing of the musculature due to a temporary functional disturbance of the nerve cells in the brain in the form of increased and reciprocal build-up of electrical discharges. This definition is certainly correct but it is much too long to remember and make use of in everyday situations. For this reason, the definition of epileptic seizures can also be simplified as the expression of a temporary functional disturbance of nerve cells, whereby the effects are dependent on which function the nerve cells involved normally have.

Every nerve cell and every cluster of nerve cells in the brain can become 'epileptic', leading to disruption or discontinuation of their normal activity.

If the cells are responsible for the sense of smell an olfactory disturbance results. If they are normally responsible for sight, the perception of light flashes or other light stimuli can be the result. If they are involved in memory, the disturbance can manifest itself in a learning disorder or possibly also in an interruption in consciousness followed by concomitant memory blackouts.

The expression "epileptic attacks" is a collective designation behind which there can be very diverse disorders. However, for many people the cause of seizures is still elusive even with the methods available today. Not every epileptic-like attack is synonymous with epilepsy.

Epilepsy still belongs to the health disorders that are met with a variety of false perceptions and prejudices by the public even though specialized knowledge particularly in this area has increased tremendously in the past decades.

The famous Greek doctor Hippocrates (460 – 375 BC) recognized that epilepsy was due to a disturbance in the brain, however it took until the 19^th century until this confirmation was also reflected in medical treatment and increasingly in the general public awareness, albeit very hesitantly.