Epilepsy affects millions of people around the world, but it’s often misunderstood beyond the fact that it causes seizures. Although seizures are a key symptom, there’s much more to know. Keep reading to learn about epilepsy’s history, why stigma still surrounds it in some places, who’s at risk, and more.

A Spectrum of Disorders

Epilepsy isn’t just one medical condition. Rather, it’s a spectrum of disorders that involve abnormal brain activity. “Epilepsy” and “seizure disorders” mean the same thing. In epilepsy, abnormal brain signals disrupt electrical activity, causing seizures. Symptoms of epileptic seizures include unusual sensations or emotions, unusual behaviors, convulsions (uncontrolled shaking), or loss of consciousness. Brain injuries, illness, and irregular brain development can all lead to these abnormal brain signals.

Approximately half of the people who’ve had a single unexplained seizure will have another, typically within six months. To be diagnosed with epilepsy, a person must have more than one seizure, and doctors must believe that more seizures are likely. Having either a seizure that lasts longer than five minutes or more than one seizure within five minutes (without regaining consciousness) is called status epilepticus, which is a medical emergency.

Some forms of epilepsy last for a limited time, but the condition is often lifelong. Although there’s no cure, many treatments are available. About 70 percent of people with seizures can control them with the right diagnosis and medications.

About 70 percent of people with seizures can control them with the right diagnosis and medications.

There are many types of seizures, and some people with epilepsy will experience more than one kind. Examples include:

• Absence seizures — Brief loss of awareness
• Atonic seizures (also called akinetic seizures) — Sudden loss of muscle tone
• Generalized tonic-clonic seizures — Stiffening and shaking
• Myoclonic seizures — Sudden muscle jerks

If you or a loved one has seizures and aren’t sure what type, talk with your healthcare provider. They can help identify the kind and suggest epilepsy treatment options.

The History of Epilepsy

Epilepsy and seizures have been recognized for thousands of years. A Babylonian medical text from around 2000 B.C.E., written on 40 tablets, describes many types of seizures known today. Back then, people believed seizures had supernatural causes. Different types were linked to various evil spirits or angry gods, so treatments focused on spiritual rituals.

Epilepsy in Ancient Greece

The word “epilepsy” comes from the Greek word “epilepsia,” meaning “to seize” or “to take hold of.” By the fifth century B.C.E., epilepsy was still considered a “sacred” disease in Greece. However, the ancient physician Hippocrates described epilepsy as a brain disorder — a radical idea at the time. He recommended physical treatments but also recognized that chronic seizures often meant the condition could not be cured.

Despite Hippocrates’ writings, for the next two millennia, people still believed epilepsy was caused by supernatural forces. People with epilepsy often faced harsh social stigma, were treated as outcasts, and were sometimes punished as witches. In many places, people with seizures were banned from going to school, working, marrying, and having children. Although some historical figures — including Julius Caesar, Tsar Peter the Great of Russia, Pope Pius IX, and Fyodor Dostoevsky — were believed to have epilepsy, most people with the condition were kept from fully participating in society.

Epilepsy in the 14th Century and Beyond

During the Renaissance, some scientists tried to show epilepsy was a physical, not spiritual, illness. By the 19th century, neurology became a recognized medical field in North America and Europe. In 1857, Sir Charles Locock introduced bromide of potassium as the first antiepileptic drug (AED).

In 1873, British neurologist John Hughlings Jackson described epilepsy in a way we understand today — seizures are caused by sudden, brief bursts of electrical energy in the brain. In 1909, epilepsy specialists (called epileptologists) formed the International League Against Epilepsy to advance research and care.

By the 1920s, German psychiatrist Hans Berger developed the electroencephalogram (EEG), a way to measure brain waves. This test showed that each type of seizure has a different brain wave pattern and helped pinpoint areas of the brain that were responsible for seizures, making surgical treatments possible. By the 1950s, epilepsy surgery became more widely available.

Development of Antiepileptic Drugs

Phenobarbital, first used in 1912, was one of the earliest seizure medicines. Other key drugs followed and were approved by the U.S. Food and Drug Administration (FDA), including:

• Phenytoin — Became available in 1938 and widely used by the 1950s
• Primidone and ethosuximide — Introduced in the 1950s and 1960s
• Carbamazepine — Discovered in the 1950s and approved in 1968

All these medicines are still prescribed today to help people with epilepsy.

In the 1970s, scientists launched a special program to help speed up the discovery of new epilepsy medicines. This program deepened researchers’ understanding of epilepsy and led to safer medicines with fewer side effects. Today, many antiepileptic drugs are available.

Learn more about treatment options for epilepsy, which extend beyond AEDs to surgery, devices, and lifestyle changes.

Social Stigma

As treatment has improved, the stigma around epilepsy has lessened. However, epilepsy isn’t always visible to others, and stigma remains, especially in parts of the world where seizures are still seen as supernatural. Many people in developing countries don’t have access to AEDs, leaving seizures untreated and discrimination unchecked.

How Common Is Epilepsy?

Epilepsy affects 1 percent of adults in the United States, according to the Centers for Disease Control and Prevention (CDC), and around 50 million people worldwide. This makes epilepsy one of the most common neurological disorders. Each year, about 45,000 new cases of epilepsy are diagnosed in U.S. children under age 18, and roughly 10.5 million children worldwide live with epilepsy.

Epilepsy affects 1 percent of adults in the United States and around 50 million people worldwide.

People of all backgrounds, races, ethnicities, and ages can be affected. Epilepsy incidence seems to be slightly higher in men than in women, according to the journal Neuroepidemiology. The condition is most common in young children and older adults.

The Epilepsy Foundation reports that among people of different ethnic and racial backgrounds:

• Epilepsy occurs more often in people of Hispanic background compared to non-Hispanic people.
• Active epilepsy (seizures not fully controlled) is more prevalent in white people than Black people.
• The lifetime prevalence of epilepsy is higher in Black people than in white people.
• About 1.5 percent of Asian Americans live with epilepsy.

Diagnosing Epilepsy

Brain imaging tools have improved greatly in recent decades. Techniques such as magnetic resonance imaging (MRI) and computed tomography (CT) scans can now detect even subtle brain lesions that may cause epilepsy.

Read more about diagnosing epilepsy.

Causes of Epilepsy

Epilepsy can have many causes, most related to problems in the brain. These include structural damage, infections like encephalitis, and genetic differences. Common risk factors for epilepsy include:

• Age
• Family history of seizures
• Head injuries, especially traumatic brain injury
• Seizures during childhood

Read more about the causes of seizures and epilepsy.

Types of Seizures

There are many types of epilepsy, and seizures fall into three general categories:

• Focal seizures — Classified based on whether there is a loss of consciousness or awareness
• Generalized seizures — Broken down into absence, tonic, atonic, clonic, myoclonic, and tonic-clonic seizures
• Unknown-onset seizures (no clear or observed start) — May later be diagnosed as focal or generalized

Learn more about seizure types and symptoms.

Find Your Team

On MyEpilepsyTeam, the social network for people with epilepsy and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with epilepsy.

What questions do you have about epilepsy? What advice or insights can you share with people who are newly diagnosed? Share your experience in the comments below, or start a conversation by posting on your Activities page.