Meaning of Epilepsy

What exactly is Epilepsy?

To know the exact meaning of Epilepsy, you need to understand what is a seizure.

You can read all about seizures here.

In summary, a seizure is a temporary electrical storm in the brain. It is caused by unregulated spikes of electricity.


If a person keeps having seizures repeatedly, he/she can be said to have a TENDENCY to have seizures. This TENDENCY to have repeated seizures is called EPILEPSY.

What are provoked seizures?

Any person’s brain can have a seizure if the provoking stimulus is very strong.

So, a person can have seizures, even if there is no underlying tendency to have seizures (Epilepsy).

For example,

  • People who consume cocaine may get seizures. This may happen even though their brain does not have a tendency to have seizures (Epilepsy).
  • People who abuse alcohol and then suddenly stop it may get seizures. This may happen even if their brain does not have a tendency to have seizures (Epilepsy).

These seizures are called provoked seizures. There is a strong agent that provoked the brain into having a seizure.

Would you say that a person who abuses cocaine has Epilepsy? Most of the time, the answer is no. There is no underlying tendency to have seizures, it is purely the cocaine which is at fault.

So, provoked seizures (even if they happen repeatedly) usually do not indicate Epilepsy.

Could you provide some examples?


John & Max:

Let’s consider two people:

  • John had a seizure after he received an Antibiotic called Imipenem – which is known to cause seizures in some people.
  • Max, a 12-pack a day alcoholic, had a seizure after he suddenly stopped drinking alcohol.

Does John or Max have Epilepsy?
No! Because both of them had seizures that happened after strong provocation.


Let’s consider another person:

  • Sid sleeps only for 6 hours on consecutive nights trying to get something done. On the third morning, he has multiple jerks of his upper body, followed by a generalized seizure.
  • He neglects this, and the next week, the same thing happens again.

Was there a strong provocation?
No, the sleep deprivation was mild.

Does Sid’s brain have a tendency to have recurrent seizures?
Yes, based on the fact that he had seizures on two successive weeks.


  • Sanjay had one unprovoked seizure when he was 3 years old.
  • He has had no seizures since then, and is now 55 years old.

Does Sanjay’s brain ever have an increased tendency to have seizures?
Probably not, considering that he had only one seizure and then none in the last 52 years.


  • Pooja had 15 seizures between 5 and 10 years of age.
  • Since that time she never had a seizure, and is now 60 years old.

Did Pooja’s brain ever have an increased tendency to have unprovoked seizures?
Yes, between 5-10 years of age, she certainly had many seizures. So she had Epilepsy.

Does Pooja’s brain still have an increased tendency to have unprovoked seizures?
Probably not, considering she has had no seizures for the past 50 years!

Therefore, it is certainly possible to outgrow your Epilepsy.

Is the history of a person always sufficient for making a diagnosis of “Epilepsy”?

If we have a long enough history, probably yes.

But – and this is a very common occurrence – let’s say a 5th person: Prasad – has a single seizure and rushes to your clinic. How can you predict whether he will have more seizures?

In addition to the history, two tests help in estimating the chance that a person will have recurrent seizures: An MRI and an EEG. An abnormal result in any of these tests indicates a higher tendency to have seizures. These tests are described in more detail here:

Is Epilepsy Common?


About 1% of the general population has Epilepsy.

An easier way to think of it is: If there are 200 people in any sort of group, e.g. a social gathering, then 1-2 people there will have Epilepsy.

What are the types of Epilepsy?

There are two basic types of Epilepsy:

  • Focal Epilepsy
  • Primary Generalized Epilepsy

These types are based on the patient’s type of seizures.

It is simple to understand these two types, if you have read the seizure article.

Some patients have both kinds of Epilepsy. In other patients, doctors are unable to make up their mind about the kind of Epilepsy the patient has.

So, the International League against Epilepsy (ILAE) has defined 4 different groups of Epilepsy.

framework for epilepsy classification the etiological framework can also be used for

So, what are “Epilepsy Syndromes”?

The ILAE defines an “Epilepsy Syndrome” as follows:

Epilepsy Syndrome
“An epilepsy syndrome refers to a cluster of features incorporating seizure types, EEG, and imaging features that tend to occur together.”

People with Epilepsy in the same “Group” share many characteristics. They may all be of the same age, have the same seizure types

Allow me explain it simply:

Around the 1950s, doctors from France realized that patients with Epilepsy tended to fall into “Groups”. They started to see patterns of age, gender, response to medications etc… Because it helped them to focus their thinking, they labelled these groups with different names.

As this practice picked up steam, more and more such groups were defined by other doctors.

Therefore, the list of Epilepsy Syndromes is ever expanding. Every once in a while, one more doctor detects a new group of people who share similar characteristics – a new Epilepsy Syndrome.

For example:

An example of patients sharing similar characteristics
A certain group could be just children who have short episodes of blanking out during the day. They never have big shaking seizures (Generalized tonic-clonic seizures). Before the children turn 15, the seizures usually stop by themselves.

We now call this Epilepsy syndrome “Childhood Absence Epilepsy” (CAE). These children are said to have “Childhood Absence Epilepsy”.

Such groupings of people (Epilepsy syndromes) are much more common in children and young adults.

In older patients, the most common Epilepsy is that starting from one area of the brain (Focal Epilepsy). In other words, Epilepsy in adults looks all the same. There is not enough grouping (clustering) of characteristics to divide adults with Epilepsy into separate syndromes.

What are a few examples of “Epilepsy Syndromes”?

Here are a few examples of Epilepsy syndromes.

Please note:

  • These are more common in children & young adults
  • Their names give you many clues about their characteristics
Epilepsy SyndromeCommon things
Childhood Absence Epilepsy (CAE)All patients are children.

They have blank staring episodes which last for a few seconds to a few minutes. These are described as “day dreaming” or being “Absent-minded” by their teachers. The poor children may be accused of not paying enough attention in class.

The EEG is very characteristic – a particular pattern called “3Hz spike-and-wave” is seen in all patients.

Juvenile Myoclonic Epilepsy (JME)As the first word indicates, this epilepsy syndrome starts in Juveniles (12 to 18 years of age).

The word “Myoclonus” means “sudden jerks”. These patients get sudden jerks of the upper body, especially when they are sleep deprived.

They may also have very violent generalized convulsions.

The EEG is again very characteristic – a particular pattern called “polyspike-and-wave” is seen in all patients.

Focal Epilepsy
  • Secondary to tumors, or knots of blood vessels, etc
These patients don’t share many common characteristics.

Focal Epilepsy can happen at any age.

These patients have “Focal Seizures”, that is – seizures that begin in one part of the brain.

Focal Epilepsy can be due to many, many different reasons such as brain tumors, or blood vessel knots, or developmental problems called “Focal Cortical Dysplasias”.

Complete list of Epilepsy Syndromes

Many other Epilepsy Syndromes have been described.

Here is a comprehensive diagram from 2010. It is not essential to remember every Epilepsy syndrome. If you have one of these, your doctor will discuss it with you.

Below the diagram, you will find a text list. It is difficult for me to write in detail about each syndrome.

But I will try my best. The Epilepsy Syndromes I have written about will be marked in blue in the list below:


Epilepsy Syndromes e1669552950800

Nenonate (First 4 weeks)

  1. Benign neonatal seizures
  2. Benign familial neonatal epilepsy (BFNE)
  3. Ohtahara syndrome
  4. Early Myoclonic encephalopathy (EME)

Infancy (in the first year of life)

  1. Febrile seizures , Febrile seizures plus (FS+)
  2. Benign infantile epilepsy
  3. Benign familial infantile epilepsy (BFIE)
  4. West syndrome
  5. Dravet syndrome
  6. Myoclonic epilepsy in infancy (MEI)
  7. Myoclonic encephalopathy in non-progressive disorders
  8. Epilepsy of infancy with migrating focal seizures


  1. Febrile seizures , Febrile seizures plus (FS+)
  2. Early onset childhood occipital epilepsy (Panayiotopoulos syndrome)
  3. Epilepsy with myoclonic atonic (previously astatic) seizures
  4. Childhood absence epilepsy (CAE)
  5. Benign epilepsy with centrotemporal spikes (BECTS)
  6. Autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE)
  7. Late onset childhood occipital epilepsy (Gastaut type)
  8. Epilepsy with myoclonic absences
  9. Lennox-Gastaut syndrome (LGS)
  10. Epileptic encephalopathy with continuous spike-and-wave during sleep (CSWS)+
  11. Landau-Kleffner syndrome (LKS)

Adolescence – Adult

  1. Juvenile absence epilepsy (JAE)
  2. Juvenile myoclonic epilepsy (JME)
  3. Epilepsy with generalized Tonic
  4. clonic seizures alone
  5. Autosomal dominant epilepsy with auditory features (ADEAF)
  6. Other familial temporal lobe epilepsies

Variable age at onset

  1. Familial focal epilepsy with variable foci (childhood to adult)
  2. Progressive myoclonus epilepsies (PME)
  3. Reflex epilepsies

Distinctive Constellations/Surgical syndromes

  1. Mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE with HS)
  2. Rasmussen syndrome
  3. Gelastic seizures with hypothalamic hamartoma
  4. Hemiconvulsion-hemiplegia-epilepsy

Epilepsies organized by structural/metabolic causes

  1. Malformations of cortical development (hemimegalencephaly, heterotopias, etc.)
  2. Neurocutaneous syndromes (tuberous sclerosis complex, Sturge-Weber, etc.)
  3. Tumor, infection, trauma, angioma, antenatal and perinatal insults, stroke, etc
Caution: This information is not a substitute for professional care. Do not change your medications/treatment without your doctor's permission.
Dr. Siddharth Kharkar

Dr. Siddharth Kharkar

Dr. Siddharth Kharkar has been recognized as one of the best neurologists in Mumbai by Outlook India magazine and India today Magazine. He is a board certified (American Board of Psychiatry & Neurology certified) Neurologist.

Dr. Siddharth Kharkar is a Epilepsy specialist in Mumbai & Parkinson's specialist in Mumbai, Maharashtra, India.

He has trained in the best institutions in India, US and UK including KEM hospital in Mumbai, Johns Hopkins University in Baltimore, University of California at San Francisco (UCSF), USA & Kings College in London.

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  • Avatar Paras Prabhu ★★★★★ 6 months ago
    Out patient is epileptic from about 10 years and her seizure gotten worse during the past year with the frequency of about 3-4 times a week.So we consulted … More Dr. Kharkar. He tried a few medicines, and within 1.5-2 months now the patient is feeling very well now. There are no seizures for 14 days currently.Dr. tried to keep medicines as minimum as possible. He also tried to keep the cost of the treatment minimum.When some of the medicines started showing side-effects, he was quick to switch the medicines to the better options.Overall I think we are getting a best of the available treatments. We thank you very much Dr. Kharkar.
  • Avatar Dr Shobha Sankhe ★★★★★ a month ago
    Dr Kharkar is gem of a doctor with tremendous patience, empathy, genuine concern for his patients .He guides them very methodically & scientifically … More for their neurological ill healthOur epilepsy patient is extremely happy with his treatment , Patient feels better by just visiting him too!May his selfless service to humanity flourish to reach all the needy patients!!
  • Avatar shrruti khanna ★★★★★ a month ago
    I consulted Dr Sidharth for my sister who has become very hyper and aggressive and we could not understand the issue. Keeping in mind she is someone with … More special needs Dr Sidharth was extremely understanding of the situation and did not put her through unnecessary investigation and avoided a very long stay at the hospital. He was infact more keen on her returning home to her natural environment. We highly appreciate Dr Sidharth for his effort and for looking into the matter with utmost care. It was a very difficult decision for my family to get my sister admitted but we are glad we did it under his care.Thankyou Doc.
  • Avatar Prashant Purohit ★★★★★ a month ago
    my name is prashant purohit. I m become completely bed ridden from last 9 months and was unable to walk. I couldnt find out the cause even after visiting … More many doctors and many hospital in Ahmedabad nd jodhpur.started losing hope. A good friend of mine suggested to visit a neurologist. After searching a lot, I came to know about Dr. Siddharth Kharkar and took his appointment in Nanavati Hospital. He examined and said that he suffered from \u201cPKD(PAROXYSMAL KNESIGENIC DYSKNESIA\u201c. He assured us to reverse this in 5 days time. And indeed this happened. I started recovering miraculously. today I am fully well fit I m walking as normal . Many Many thanks to Dr. Siddharth Kharkhar sir for giving me a new life.
  • Avatar Sanjay Pradhan ★★★★★ 7 months ago
    Dr. Kharkar is truly exceptional. He is extremely knowledgeable. But simultaneously, he is extremely patient and kind - taking the time and care to respond … More to all the questions. It is rare to come across a doctor who is not in a hurry to get on to the next patient, but instead, focuses on the one in front with full attention, expertise and compassion. A great experience.
  • Avatar N N ★★★★★ a year ago
    We visited Dr. Kharkhar for treatment regarding my mum - who is a multi-stroke patient and has aphasia. Certain medications were creating complications … More with her condition and Dr. Kharkhar was able to help mitigate the issue. We found him and his approach to be incredibly compassionate, considerate, individualized and patient-friendly. He advice is astute, up-to-date and empathetic. His treatment always comes from a deeply human place and is about seeing how to help the patient and their caregivers feel more at ease. Something that is quite rare and refreshing within the medical community.We feel that he genuinely cares about the patients that he is treating and is always kind and respectful in his communication. Moreover, his admin team is very efficient and prompt and it's a pleasure to deal with them.Would highly recommend Dr Kharkhar himself - though we must say our experience with Nanavati hospital itself has been less than ideal.Hope this helps.
  • Avatar Manish Ranjan ★★★★★ a year ago
    I have been visiting Dr Kharkar for treatment of my father. He is a very friendly doctor. He listens to our concerns with lot of patience. He also explains … More the issue in much greater details. He has really been of great help. My father is much better now.
  • Avatar Pinakin Shah ★★★★★ a year ago
    One of the best Dr. Gives complete attention and time to listen to patient's history, issues. Explains various options of treatment with pros and … More cons.
  • Avatar Lawrence Castellino ★★★★★ a year ago
    Exceptional experience with an expert,Dr. Kharkar is a knowledge house. It is rare nowadays to find doctors with patience, knowledge, and a flair for … More handling patient’s questions, besides Dr. Kharkar’s bedside manners are exemplary. I am privileged to be treated by such an amazing soul. I have told him and will repeat it here that “I am advancing my move back to India although I am a US Citizen, because I know I am in good hands and will be well taken care of. Thanks Dr. Kharkar for your selfless service!
  • Avatar Hemant Kansara ★★★★★ a year ago
    Great doctor!! Really appreciate.The doctor diagnosed to my sister correctly and start treatment, she has good improvement after taking medicine prescribed … More by doctor as no epilepsy attake. We have good experience with the doctor. Thank you

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