ABSTRACT
Epilepsy affects approximately 1 in 200 people. In over 60% of cases there are no identifiable causes. Treatment may be straightforward, such as the correction of hypoglycaemia, however in some cases the seizure may herald a more sinister condition. The history favours transient ischaemic attack (TIA), stroke, undiagnosed diabetes, a space-occupying lesion, and alcohol use or withdrawal. Consciousness relies on the intact function of the cerebral hemispheres and reticular activating system, and adequate provision of oxygen and nutrients. Seizures are caused by abnormal spontaneous electrical discharge in any part of the brain. Normal neuronal functioning is vitally dependent on the tightly regulated structural and functional environment of the neurones. Status epilepticus is defined as a seizure lasting for more than 30 minutes, or repeated seizures without any intervening consciousness. Prompt investigation is crucial to establish whether there are any treatable causes present.
