Ahead of Epilepsy Awareness Day: Here’s everything you need to know about the disease

The human brain works as an extremely complex electrical network. Billions of nerve cells communicate with each other through precisely measured electrical pulses. In epilepsy, this mechanism is disrupted. A group of cells in the brain begins to operate in abnormal synchronization, at a rapid and uncontrolled rate, and creates an electrical storm that leads to a seizure.

The source of the disturbance varies from person to person. In children it is often a congenital genetic factor, in younger people the injury is sometimes related to a head injury or a brain infection, while in the elderly epilepsy often appears after a stroke, a brain tumor or as part of degenerative diseases such as Alzheimer’s.

Contrary to the public image, epilepsy is not a single disease but a broad group of syndromes. Some seizures are only focal, that is, limited to a certain area of ​​the brain. In such situations the person may experience a brief sense of disconnection, a smell or taste that does not exist, a temporary distortion of vision or an intense feeling of deja vu. Sometimes these are short bouts of absence, especially in children, which are manifested by staring for only a few seconds. These attacks tend to be missed or interpreted as attention disorder or daydreaming.

At the other end of the spectrum are the general seizures, those accompanied by loss of consciousness, muscle stiffness and convulsions. These are the attacks that created fear and stigma over the years, but even here the reality has changed. Thanks to early treatment, careful monitoring and individualized medication, most patients no longer have severe attacks with high frequency.

The diagnosis has also undergone a revolution. In the past, the diagnosis was mainly based on the description of the seizure and a short EEG test, which did not always manage to capture abnormal activity. Today, prolonged monitoring is used, sometimes for days, and with advanced means that enable continuous monitoring of brain activity. Wearable devices, including smart watches, collect physiological data, and algorithms learn to identify pre-seizure patterns. In some cases, an early warning is received that allows you to get ready, lie down, stay away from dangers and sometimes even prevent the attack.

Advanced imaging tests, such as MRI and PET, currently provide not only an anatomical image but also functional information about active areas of the brain. The combination of the data allows doctors to locate tiny epileptic foci that previously remained hidden, and to adjust treatment more precisely.

One of the most significant developments in recent years is progress in the field of genetics. In recent years, many mutations related to the activity of ion channels in nerve cells have been identified. These findings led to a change in the therapeutic approach. Instead of trying different drugs until the balance is found, it is now possible in some cases to carry out genetic sequencing and tailor a targeted treatment to the specific defect. This means higher efficiency and fewer side effects, especially among children with complex epileptic syndromes.

Drug treatment remains the cornerstone of dealing with epilepsy. About 70% of patients reach a good balance through medication alone. The new drugs work in a more selective way, impair alertness and memory less and enable almost full daily functioning. For the patients who do not respond to drug treatment, approximately 30% of those diagnosed, additional solutions have been developed.

One of them is reactive neurostimulation, a system that is implanted in the brain and monitors the electrical activity in real time. When the system detects the beginning of abnormal activity, it sends a counter pulse that suppresses the attack in its early stages. At the same time, medical diets such as the ketogenic diet have become part of the toolbox, especially in children. Changing the brain’s energy source from sugar to fat has been shown to reduce seizure frequency in some patients.

A topic that continues to worry many parents is febrile convulsions. But a febrile convulsion is not epilepsy. This is a reaction of a young brain to a sharp increase in body temperature, a phenomenon that occurs in about 3% of children. Despite the dramatic appearance, a simple febrile seizure does not cause brain damage and does not indicate a high future risk of epilepsy. The treatment remains simple and relaxing, lying on the side, monitoring the duration of the attack and lowering the temperature.

Along with medical progress, many myths still exist. Contrary to popular belief, a person during an attack cannot swallow his tongue, and putting objects in his mouth is dangerous. Epilepsy is not always hereditary, and only a minority of patients are sensitive to flashing lights. This information is essential not only for patients but also for the environment, teachers, employers and family members.

The main challenge that remains is the stigma. Despite the huge improvement in treatment, many are still afraid to reveal the diagnosis. In practice, balanced epilepsy patients work in every field, serve in the IDF in various positions, drive cars after a period of balance and start families. Public awareness is the most powerful tool for change.

International Epilepsy Awareness Day reminds that the disease does not define the person. It is a medical characteristic of a complex electrical system, one that can be understood, monitored and treated. In 2026, with the existing technology and accumulated knowledge, epilepsy is no longer a destiny, but a medical condition with which a full, active and safe life can be lived.

During an attack it is important to act quietly, quickly and safely, even if the sight is stressful. The person should be placed on their side to avoid inhaling saliva or vomiting. Pad his head and body to prevent injuries. Do not try to stop the convulsions and do not hold the limbs by force. Do not put any object in the mouth, not fingers, not a spoon, not a cloth, as this may cause broken teeth or serious injury. It is important to release tight clothes around the neck. Call MDA 101 at the same time, leave the machine on speaker, give your location and stay on the line for instructions.