Epilepsy is a chronic neurological disorder characterised by recurrent unprovoked seizures — caused by abnormally excessive or synchronous electrical activity in the brain. It is not a single disease but rather a group of disorders with diverse causes, seizure types and treatments. Epilepsy affects approximately 50 million people globally — one of the world's most common neurological conditions, occurring in all ages, sexes, ethnicities and geographies.

What causes epilepsy?

Structural causes: stroke, traumatic brain injury, brain tumours, cortical malformations. Infectious causes: neurocysticercosis (Taenia solium — the most common preventable cause), meningitis, HIV, cerebral malaria. Genetic causes: various ion channel and receptor mutations. Metabolic causes: hypoglycaemia, hyponatraemia. Immune causes: autoimmune encephalitis. In approximately 50% of cases, the cause is unknown ("idiopathic").

What is the epilepsy treatment gap?

The epilepsy treatment gap is the proportion of people with active epilepsy not receiving appropriate treatment — approximately 75% in LMICs and up to 90% in parts of Africa. Causes: unavailability of antiseizure medicines in primary care; high cost; lack of trained healthcare workers to diagnose and manage epilepsy; cultural and religious beliefs attributing epilepsy to supernatural causes; and stigma preventing treatment-seeking.

Can epilepsy be treated effectively?

Yes — 70% of people with epilepsy can become seizure-free with appropriate antiseizure medication. First-line medicines (phenobarbital, carbamazepine, valproate) are inexpensive and on the WHO Essential Medicines List. For drug-resistant epilepsy (30%), surgical resection, vagal nerve stimulation or dietary therapies (ketogenic diet) offer additional options. Primary health care integration of epilepsy management — as promoted by WHO IGAP — can close the treatment gap.

What is the WHO IGAP 2022-2031?

The WHO Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders 2022-2031 provides a comprehensive framework for addressing epilepsy through: promoting epilepsy research; improving surveillance; strengthening health systems to include neurological care in primary health care; reducing treatment gaps; and addressing stigma. It targets a 50% reduction in the epilepsy treatment gap by 2031.

What is neurocysticercosis?

Neurocysticercosis — from Taenia solium (pork tapeworm) larvae migrating to the brain — is the most common preventable cause of epilepsy in endemic regions (Latin America, Sub-Saharan Africa, South Asia). It accounts for up to 30% of epilepsy in endemic areas. Prevented by improved pig management, latrine use, meat inspection and community treatment. Treated with albendazole and praziquantel plus anti-inflammatory steroids.

Sudden Unexpected Death in Epilepsy (SUDEP) occurs in approximately 1 in 1,000 people with epilepsy per year — making it a significant cause of premature death. It typically occurs unwitnessed during or after a nocturnal convulsive seizure. The mechanism involves cardiac and respiratory dysfunction following a seizure. Seizure control through medication is the most important preventive measure; night-time monitoring and CPAP for sleep apnoea may also help.

What is stigma in epilepsy?

In many cultures, epilepsy is attributed to supernatural possession, witchcraft or contagion — leading to stigma, social exclusion, discrimination in education and employment, and barriers to marriage. Stigma is a leading reason why people with epilepsy do not seek treatment. People touched by someone having a seizure may be unnecessarily prevented from doing so by fears of contagion. Anti-stigma education and community-based epilepsy programmes are essential components of IGAP.

What is first aid for a seizure?

For generalised tonic-clonic (grand mal) seizures: stay calm; time the seizure; keep the person safe by cushioning the head and removing dangerous objects; turn them on their side (recovery position) when convulsions stop; stay until they are fully alert. Do NOT: hold them down; put anything in their mouth; give water until fully alert. Call emergency services if: the seizure lasts >5 minutes; the person doesn't regain consciousness; there are multiple seizures; or the person is injured.

How does epilepsy affect children?

Epilepsy begins in childhood or adolescence in approximately 60% of cases. Childhood epilepsies include: absence seizures (brief staring spells); juvenile myoclonic epilepsy; infantile spasms (West syndrome — requiring urgent treatment to prevent developmental regression); and febrile seizures (seizures associated with fever in young children — usually benign). Uncontrolled epilepsy in children causes neurocognitive effects and disrupts education.

What is drug-resistant epilepsy?

Approximately 30% of people with epilepsy have drug-resistant (pharmacoresistant) epilepsy — seizures persisting despite adequate trials of two tolerated, appropriately chosen antiseizure medicines. These patients should be evaluated for epilepsy surgery — resecting or disconnecting the seizure focus — which achieves seizure freedom in 60-80% of suitable candidates. Other options: vagal nerve stimulation, deep brain stimulation, ketogenic diet, newer ASMs.

How does GMJ News cover epilepsy?

GMJ News covers WHO IGAP progress, antiseizure medicine access in LMICs, neurocysticercosis as a preventable cause, anti-stigma campaigns and SUDEP awareness. Epilepsy management quality in Georgian hospitals — including antiseizure medicine availability and neurological consultation access — is relevant to PHIG's healthcare quality work.

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Epilepsy

GMJ News knowledge hub · last reviewed September 2026 · Georgian Medical Journal

Summary Statistics Glossary GMJ news FAQ Documents Organizations Research

Epilepsy — a chronic neurological disorder characterised by recurrent seizures — affects approximately 50 million people worldwide, making it one of the world's most common neurological diseases, yet 70% of people with epilepsy could live seizure-free with appropriate treatment (WHO). The treatment gap is staggering: 75% of people with epilepsy in LMICs receive no treatment at all — largely because of the cost, availability and cultural stigma associated with the disease. The WHO Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders 2022-2031 targets closing this gap.

Key messages

50 million affected

Epilepsy — a chronic neurological disorder characterised by recurrent unprovoked seizures — affects approximately 50 million people worldwide, making it one of the world's most common neurological diseases (WHO).

70% could be seizure-free

70% of people with epilepsy could live seizure-free with appropriate antiseizure medication (ASM). Yet in LMICs, 75% of people with epilepsy receive no treatment — the largest treatment gap of any major neurological condition.

IGAP 2022-2031

The WHO Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders (IGAP) 2022-2031 targets closing the epilepsy treatment gap and reducing the burden of epilepsy through primary health care integration.

Stigma is a major barrier

In many cultures, epilepsy is associated with supernatural beliefs, witchcraft or contagion — causing severe stigma, social exclusion and discrimination in education and employment. Stigma is a leading barrier to treatment-seeking.

Preventable causes

Up to 25% of epilepsy is preventable: through prevention of traumatic brain injury (helmets, road safety); prevention of stroke (blood pressure control); prevention of perinatal brain injury (skilled birth attendance); and control of neurocysticercosis (Taenia solium) — the leading preventable cause of epilepsy in endemic areas.

SUDEP risk

Sudden Unexpected Death in Epilepsy (SUDEP) — unexplained death in an otherwise healthy person with epilepsy — is a significant mortality risk, occurring in approximately 1 in 1,000 people with epilepsy per year. Seizure control through medication is the primary protective measure.

Key statistics

50M

people with epilepsy

WHO

70%

could be seizure-free with treatment

WHO

75%

treatment gap in LMICs

WHO

80%

of people with epilepsy in LMICs

WHO

2.4M

new epilepsy cases/year

WHO

25%

of epilepsy preventable

WHO

Epilepsy treatment gap (% with active epilepsy not receiving treatment) by region — WHO/ILAE

Source: WHO / International League Against Epilepsy. Treatment gap is highest in Africa and parts of Asia.

Glossary of key terms

Epilepsy
WHO/ILAEA neurological disorder defined by: at least two unprovoked seizures >24 hours apart; one unprovoked seizure with ≥60% recurrence probability; or an epilepsy syndrome. Characterised by recurrent seizures from abnormal electrical brain activity.

Seizure
ILAEA transient occurrence of signs and/or symptoms caused by abnormally excessive or synchronous neuronal activity in the brain. Types: focal (arising in one brain region) or generalised (involving both hemispheres from onset). Manifestations: motor, sensory, autonomic or psychic.

Antiseizure medication (ASM)
WHO EMLMedicines that reduce seizure frequency and severity. First-line ASMs (phenobarbital, carbamazepine, valproate, lamotrigine) are on the WHO Essential Medicines List. 70% of people with epilepsy can become seizure-free with appropriate ASM — but access in LMICs is severely limited.

Treatment gap
WHO/ILAEThe proportion of people with active epilepsy who do not receive appropriate treatment. Globally approximately 50%; in LMICs up to 75-90%. Caused by drug unavailability, cost, lack of diagnosis, stigma, cultural barriers and insufficient neurological workforce.

Neurocysticercosis
WHOBrain infection by Taenia solium larvae (pork tapeworm) — the leading preventable cause of epilepsy in endemic regions (Latin America, Africa, Asia). Prevented by improved sanitation, pig management and inspection of pork. Treated with albendazole/praziquantel.

SUDEP
Epilepsy FoundationSudden Unexpected Death in Epilepsy — unexplained death in an otherwise healthy person with epilepsy. Affects ~1 in 1,000 people with epilepsy per year; highest risk with uncontrolled seizures. Seizure control through medication is the primary preventive measure.