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WHO HAS EPILEPSY?
At least one person in 200 (about 300,000 in the UK) suffers from epilepsy, and this is probably a conservative estimate. The figure may be nearly as high as one person in 100.
Epilepsy is very much a disease of the young, partly because the brain is always more excitable in children than it is in adults. If you are going to develop epilepsy, you are most likely to do so in childhood or adolescence. About one quarter of people with epilepsy will have developed the condition by the time they start primary school at the age of five; half will have done so by the time they move on to secondary school at 11. By the age of 18, three-quarters of those who are going to develop the condition will have done so, and, by the age of 20, 90 per cent. There is a further and final peak in middle to old age, this time because of damage to the brain by degenerative disease.
EPILEPSY AND INHERITANCE
EpilepsyThe genes which determine brain excitability, and which are inherited, have their strongest effect in childhood. That is why most people who develop epilepsy do so then. Excitability ‘peaks’ at the age of about 16, and thereafter the brain becomes progressively less excitable. This kind of inherited epilepsy used to be called ‘idiopathic epilepsy’, meaning simply that no one knew what caused it.
Other developmental changes are now thought to be important causes of epilepsy. During the second three months of pregnancy, as the brain develops, cells migrate from one position in the brain to another. Sometimes this migration goes wrong and leads to a condition known as heterotopia. In some people these areas of heterotopia are intensely epileptogenic (that is, very likely to give rise to seizures). Another common congenital (developmental) cause of epilepsy is the dysembryoplastic neuroepithelial tumour, or DNT, a lesion which is found most frequently in the temporal lobe though it can occur elsewhere in the brain.
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