According to the latest epidemiological data in China, the overall prevalence of epilepsy in the country is 7.0 per thousand, with an annual incidence rate of 28.8 per 100,000. The prevalence of active epilepsy stands at 4.6%.Based on these figures, China is estimated to have approximately 9 million epilepsy patients, with 5 to 6 million experiencing active epilepsy. Additionally, around 400,000 new cases emerge annually, making epilepsy the second most common neurological disorder in China after headaches.
【Science Lecture】Caring for Epilepsy Starts with Accurate Scientific Understanding!
Is epilepsy contagious? Absolutely not. However, misconceptions, fear, and discrimination surrounding epilepsy are highly "contagious"!
Epilepsy is an ancient disease. In premodern times, the spectacle of seizures shrouded it in an aura of "supernatural" mystery. The World Health Organization's Epilepsy Report has repeatedly emphasized that epilepsy is a stigmatized condition, with patients often facing discrimination and even violations or deprivation of their basic rights.Therefore, the fight against epilepsy is not only against the disease itself, but also against negative emotions, misconceptions, and even discrimination.
In reality, epilepsy is simply a common chronic condition—nothing to fear. Approximately two-thirds of patients can control their seizures with antiepileptic drugs, enabling them to work and live like anyone else.
Epilepsy is not a contagious disease; it is an abnormal manifestation caused by certain underlying factors. Our role is to empower patients to courageously confront epilepsy, enhance their quality of life, and facilitate their reintegration into society.【Science Lecture】The Relationship Between Epilepsy, Sleep, and Sleep Disorders?
Sleep is a vital component of daily life. Among epilepsy patients, the incidence of sleep disorders is 2 to 3 times higher than in the general population, indicating that sleep disturbances are relatively common in this group.
Epilepsy and sleep mutually influence and depend on each other. On one hand, sleep deprivation may lower the seizure threshold and increase seizure frequency. On the other hand, epileptic seizures can disrupt the wake-sleep cycle and sleep architecture, creating a vicious cycle.
Impact of Epilepsy on Sleep
Sleep architecture in epilepsy patients is unstable, particularly among those with poorly controlled seizures or nocturnal episodes. Polysomnography reveals reduced total sleep time, prolonged sleep latency, fragmented sleep patterns, decreased sleep efficiency,increased transitions between sleep stages, more awakenings during sleep, prolonged light sleep periods, and shortened deep sleep periods.
Common sleep disorders in epilepsy patients include night terrors, sleepwalking, disorganized awakenings during sleep, behavioral disorders during rapid eye movement (REM) sleep, obstructive sleep apnea syndrome, and restless legs syndrome.Epilepsy patients with sleep disorders often experience poor nighttime sleep quality or inadequate physical recovery after sleep. This leads to daytime symptoms like excessive sleepiness, behavioral disturbances, inattention, and impulsive hyperactivity, significantly impacting daily functioning and learning.
Which epilepsy patients are more prone to sleep disorders? Research indicates that those with frequent nocturnal seizures, those treated with multiple antiepileptic drugs or drug-resistant epilepsy, and those with concurrent developmental delays or intellectual disabilities are more likely to develop sleep disorders.
Additionally, certain antiepileptic drugs (such as benzodiazepines, phenytoin, and phenobarbital) can affect sleep architecture, most commonly causing daytime drowsiness and sleepiness. However, the impact of antiepileptic drugs on sleep architecture varies among individuals and is not uniform across all patients.Some antiepileptic drugs have little to no effect on sleep, such as sodium valproate, carbamazepine, and lamotrigine.Certain epilepsies or syndromes are closely linked to sleep. For example, benign childhood epilepsy with central-temporal spikes—the most common age-related epilepsy syndrome in children—primarily occurs shortly after falling asleep or upon waking in the morning. Staying up late or sleep deprivation may trigger seizures in these children.For children with autosomal dominant nocturnal frontal lobe epilepsy, seizures predominantly occur during nighttime sleep and may recur multiple times, severely disrupting sleep structure and quality.
Epilepsy and sleep are often closely intertwined and mutually influential. Therefore, epilepsy treatment involves not only actively controlling seizures but also improving sleep quality and fostering healthy sleep habits, which further aids seizure management.Therefore, epilepsy patients should ensure adequate sleep, avoid staying up late, and develop the habit of sleeping at regular times each night to prevent triggering seizures. Attention should also be paid to sleeping positions: adopt supine or lateral positions and avoid prone sleeping whenever possible, especially for patients with frequent nocturnal seizures to prevent accidents like suffocation.When epilepsy patients experience sleep disorders, these conditions can lower the seizure threshold, potentially increasing seizure frequency. Therefore, identifying the causes of sleep disorders and providing active treatment is crucial. Additionally, when selecting antiepileptic drugs, consider their impact on sleep and opt for medications with minimal sleep-disrupting effects whenever possible.【Science Lecture】Why Do Epilepsy Patients Need Regular EEG Follow-ups?
Seizures result from abnormal neuronal discharges. The electroencephalogram (EEG) is the most direct and convenient method for reflecting brain electrical activity, serving as the most crucial auxiliary diagnostic tool for confirming seizures and determining seizure types.Based on medical history, physical examination, EEG, and brain MRI findings, a preliminary epilepsy diagnosis can be established. However, for patients with clinically strong epilepsy suspicion but normal EEG results, repeat EEGs are recommended. This may include extended monitoring to capture sleep-related or seizure activity, aiding in definitive diagnosis.
Repeat EEGs are also essential during epilepsy treatment to assess therapeutic response and guide management. For patients considering dose reduction and/or discontinuation, a normal follow-up EEG is a key basis for deciding whether to proceed (excluding some age-related epilepsy syndromes). If seizures recur during dose tapering, reduction must be halted.Patients who have discontinued medication but experience recent suspected seizures generally require a follow-up EEG.
How often should EEGs be repeated?
There is no absolute standard. For patients with well-controlled seizures on antiepileptic drug therapy, EEGs are recommended every 3 to 6 months. This should be determined by considering the patient's specific condition, access to medical care, and other factors.Overall, patients are advised to undergo at least 1–2 EEGs annually.
Our recommendation: Regular EEG monitoring during treatment is crucial for epilepsy diagnosis and management!
【Science Corner】Can childhood seizures develop into epilepsy?
Febrile seizures are the most common cause of childhood seizures and generally have a favorable prognosis. If the seizure is brief, recovery is rapid, and episodes are infrequent, brain damage is typically minimal—some even consider it negligible—with little impact on the child's future intelligence, learning, or behavior.However, if seizures involve significant oxygen deprivation (e.g., cyanosis of face and lips), prolonged duration (generally considered over 3 minutes), or recurrent episodes, they may cause some brain damage. Determining whether damage exists, its severity, and potential future impact is challenging to assess and predict. A small number of epilepsy cases originating from febrile seizures may be associated with intellectual disability.