For years, doctors have reassured epilepsy patients that seizures are relatively benign. While a fall during a seizure may cause injury, the surge of electricity in the brain does no actual damage, patients were told.
But mounting evidence now suggests that repeated seizures can indeed harm the brain – or, in rare cases, even lead to death.
In the past decade, research in epilepsy has exploded. In part, the boom has been driven by advances in biology and technology, like the mapping of the genome and the continuing miniaturisation of electronics.
But largely, it has been driven by a new recognition that seizures themselves are harmful. Mounting data point to damage to the hippocampus, the part of the brain responsible for laying down new memories, as the cumulative effect of a lifetime of uncontrolled seizures.
Recent studies suggest that seizures beget seizures: each electrical surge in the brain causes changes that make future seizures more likely.
Doctors are also realising that patients with seizures that are not suppressed by drugs or surgery are at higher risk of dying prematurely.
A syndrome called sudden unexpected death in epilepsy patients, or Sudep, appears to be much more common than previously thought. No one is sure exactly what happens in the syndrome, but the suspicion is that an electrical short circuit either turns off respiration or the heart.
Among patients with severe epilepsy, about 10 to 15 of 10,000 die unexpectedly each year, according to Dr Robert S. Fisher, a professor of neurology at Stanford. Often patients and their families know nothing about the syndrome, until there is a death.
The New York Times
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