A COMPREHENSIVE REVIEW ON EPILEPSY: EPIDEMIOLOGY, NEUROCHEMICAL BASIS, STRUCTURAL CLASSIFICATION, AND ETIOLOGY

Epilepsy is a chronic neurological disorder characterized by an ongoing tendency to have unprovoked seizures, which are caused by abnormal electrical activity in the brain's cortex. Beyond the seizures themselves, people living with epilepsy can also experience various deficits related to their neurobiology, cognition, psychology, and social life. Globally, this condition affects over 50 million individuals. Other neuromodulators, including serotonin, dopamine, and acetylcholine, are also known to influence an individual's seizure threshold. The 2017 ILAE (International League Against Epilepsy) classification system categorizes seizures as focal, generalized, or of unknown onset. In contrast, epilepsy itself is classified based on its etiology, which includes genetic, structural, metabolic, infectious, immunologic, or unknown origins. Clinically, epilepsy disorders range significantly, from uncomplicated focal seizures to highly complex disorders like Lennox-Gastaut and Dravet syndromes. Antiepileptic medications (AEDs) like valproate, carbamazepine, lamotrigine, and levetiracetam are commonly used in first-line therapy. However, alternative therapies such as the ketogenic diet, vagus nerve stimulation (VNS), and various surgical options are taken into consideration for the approximately 30-40% of individuals with drug-resistant epilepsy (DRE). In India, treatment faces significant obstacles, such as limited access to essential medications, a shortage of specialist neurologists, and persistent social stigma. Looking forward, advancements in genetics, precision pharmacology, and AI-driven diagnostics offer exciting potential for developing highly individualized epilepsy treatment strategies.