Epilepsy is one of the most common serious brain conditions, affecting over 70 million people worldwide. Its incidence has a bimodal distribution with the highest risk in infants and older age groups. Progress in genomic technology is exposing the complex genetic architecture of the common types of epilepsy, and is driving a paradigm shift. Epilepsy is a symptom complex with multiple risk factors and a strong genetic predisposition rather than a condition with a single expression and cause. These advances have resulted in the new classification of epileptic seizures and epilepsies. A detailed clinical history and a reliable eyewitness account of a seizure are the cornerstones of the diagnosis. Ancillary investigations can help to determine cause and prognosis. Advances in brain imaging are helping to identify the structural and functional causes and consequences of the epilepsies. Comorbidities are increasingly recognised as important aetiological and prognostic markers. Antiseizure medication might suppress seizures in up to two-thirds of all individuals but do not alter long-term prognosis. Epilepsy surgery is the most effective way to achieve long-term seizure freedom in selected individuals with drug-resistant focal epilepsy, but it is probably not used enough. With improved understanding of the gradual development of epilepsy, epigenetic determinants, and pharmacogenomics comes the hope for better, disease-modifying, or even curative, pharmacological and non-pharmacological treatment strategies. Other developments are clinical implementation of seizure detection devices and new neuromodulation techniques, including responsive neural stimulation.

中文翻译：

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成人癫痫病

癫痫病是最常见的严重脑部疾病之一，全世界有七千万人受到影响。其发病率呈双峰分布，在婴儿和较大年龄组中风险最高。基因组技术的进步暴露了癫痫病常见类型的复杂遗传结构，并推动了范式的转变。癫痫是具有多种危险因素和强烈的遗传易感性的症状复合体，而不是具有单一表达和病因的病症。这些进展导致了癫痫发作和癫痫病的新分类。详细的临床病史和癫痫发作的可靠目击者描述是诊断的基础。辅助检查有助于确定病因和预后。脑成像技术的进步正在帮助确定癫痫的结构和功能原因及后果。合并症日益被认为是重要的病因和预后指标。抗癫痫药可能会抑制多达三分之二的个体癫痫发作，但不会改变长期预后。癫痫手术是在某些患有耐药性局灶性癫痫的个体中实现长期癫痫发作自由的最有效方法，但可能使用的不够。随着对癫痫，表观遗传决定因素和药物基因组学逐渐发展的了解，人们希望有更好，疾病缓解甚至治愈的药理和非药理治疗策略。