Editing Epilepsy (section)

==Prognosis==
[[File:Epilepsy world map-Deaths per million persons-WHO2012.svg|thumb|upright=1.4|Deaths due to epilepsy per million persons in 2012 {{Div col|small=yes|colwidth=10em}}{{legend|#ffff20|0–7}}{{legend|#ffe820|8–10}}{{legend|#ffd820|11–13}}{{legend|#ffc020|14–17}}{{legend|#ffa020|18–21}}{{legend|#ff9a20|22–28}}{{legend|#f08015|29–37}}{{legend|#e06815|38–67}}{{legend|#d85010|68–100}}{{legend|#d02010|101–232}}{{div col end}}]]

Epilepsy is generally considered a chronic neurological condition, but its long-term course can vary widely depending on factors such as seizure type, underlying cause, and response to treatment. Although epilepsy is not typically "cured," in many cases it may be considered resolved. According to the ILAE, epilepsy is considered to be resolved in individuals who have been seizure-free for at least 10 years, with no antiseizure medications for the last 5 of those years.<ref name="Fisher2014" />

Approximately 60–70% of individuals with epilepsy achieve good seizure control with appropriate antiseizure medications, and many can maintain long-term remission.<ref name="Ead2012" /> However, outcomes vary significantly by epilepsy type and etiology. Early treatment response is one of the strongest predictors of long-term outcome, with poor early control correlating with lower chances of remission. Several factors — such as structural brain abnormalities, comorbid developmental disorders, or a high frequency of seizures at onset — have been associated with worse outcomes, although findings are not always consistent.<ref>{{Cite journal |last=Mohanraj |first=Rajiv |last2=Brodie |first2=Martin J. |date=2013-06-01 |title=Early predictors of outcome in newly diagnosed epilepsy |url=https://www.sciencedirect.com/science/article/pii/S1059131113000368 |journal=Seizure |volume=22 |issue=5 |pages=333–344 |doi=10.1016/j.seizure.2013.02.002 |issn=1059-1311|doi-access=free }}</ref>

Epilepsy disproportionately affects low- and middle-income countries, where nearly 80% of the global epilepsy population resides.<ref>{{Cite journal |last=Vergonjeanne |first=Marion |last2=Auditeau |first2=Emilie |last3=Erazo |first3=Daniells |last4=Luna |first4=Jaime |last5=Gelle |first5=Thibaut |last6=Gbessemehlan |first6=Antoine |last7=Boumediene |first7=Farid |last8=Preux |first8=Pierre-Marie |last9=QUINET Collaboration |date=2021-09-21 |title=Epidemiology of Epilepsy in Low- and Middle-Income Countries: Experience of a Standardized Questionnaire over the Past Two Decades |url=https://karger.com/ned/article-abstract/55/5/369/825238/Epidemiology-of-Epilepsy-in-Low-and-Middle-Income?redirectedFrom=fulltext |journal=Neuroepidemiology |volume=55 |issue=5 |pages=369–380 |doi=10.1159/000517065 |issn=0251-5350}}</ref> In these countries, to 75% of individuals with epilepsy do not receive the treatment they need.<ref name="WHO2023" /> Untreated epilepsy is associated with elevated risk of injury, psychiatric comorbidities, and early death, including sudden unexpected death in epilepsy (SUDEP). 

===Mortality===
People with epilepsy may have a higher risk of premature death compared to those without the condition.<ref name=Hit2007/> This risk is estimated to be between 1.6 and 4.1 times greater than that of the general population.<ref name=Mosh2009>{{cite book | veditors = Shorvon S, Perucca E, Engel J |title=The treatment of epilepsy|year=2009|publisher=Wiley-Blackwell|location=Chichester, UK|isbn=978-1-4443-1667-4|page=28|url=https://books.google.com/books?id=rFFzFzZJtasC&pg=PA28|edition=3rd|url-status=live|archive-url=https://web.archive.org/web/20160610155113/https://books.google.com/books?id=rFFzFzZJtasC&pg=PA28|archive-date=10 June 2016}}</ref> The greatest increase in mortality from epilepsy is among the elderly.<ref name=Mosh2009/> Those with epilepsy due to an unknown cause have a relatively low increase in risk.<ref name=Mosh2009/>

Mortality is often related to the underlying cause of the seizures, status epilepticus, suicide, [[major trauma|trauma]], and [[sudden unexpected death in epilepsy]] (SUDEP).<ref name=Hit2007>{{cite journal | vauthors = Hitiris N, Mohanraj R, Norrie J, Brodie MJ | title = Mortality in epilepsy | journal = Epilepsy & Behavior | volume = 10 | issue = 3 | pages = 363–376 | date = May 2007 | pmid = 17337248 | doi = 10.1016/j.yebeh.2007.01.005 }}</ref> Death from status epilepticus is primarily due to an underlying problem rather than missing doses of medications.<ref name=Hit2007/> The risk of suicide is between two and six times higher in those with epilepsy;<ref name=Bagary2011>{{cite journal | vauthors = Bagary M | title = Epilepsy, antiepileptic drugs and suicidality | journal = Current Opinion in Neurology | volume = 24 | issue = 2 | pages = 177–182 | date = April 2011 | pmid = 21293270 | doi = 10.1097/WCO.0b013e328344533e }}</ref><ref name=Mula2013>{{cite journal | vauthors = Mula M, Sander JW | title = Suicide risk in people with epilepsy taking antiepileptic drugs | journal = Bipolar Disorders | volume = 15 | issue = 5 | pages = 622–627 | date = August 2013 | pmid = 23755740 | doi = 10.1111/bdi.12091 }}</ref> the cause of this is unclear.<ref name=Bagary2011/> SUDEP appears to be partly related to the frequency of generalized tonic-clonic seizures<ref name=Ry2013>{{cite journal | vauthors = Ryvlin P, Nashef L, Tomson T | title = Prevention of sudden unexpected death in epilepsy: a realistic goal? | journal = Epilepsia | volume = 54 | issue = Suppl 2 | pages = 23–28 | date = May 2013 | pmid = 23646967 | doi = 10.1111/epi.12180 | doi-access = free }}</ref> and accounts for about 15% of epilepsy-related deaths;<ref name="Fast2012">{{cite book |title=Fast facts: epilepsy |vauthors=Kwan P |publisher=Health Press |year=2012 |isbn=978-1-908541-12-3 |edition=5th |location=Abingdon, Oxford, UK |page=10}}</ref> it is unclear how to decrease its risk.<ref name=Ry2013/> Risk factors for SUDEP include nocturnal generalized tonic-clonic seizures, seizures, sleeping alone and medically intractable epilepsy.<ref name="pmid36270688">{{cite journal | vauthors = Kløvgaard M, Sabers A, Ryvlin P | title = Update on Sudden Unexpected Death in Epilepsy | journal = Neurologic Clinics | volume = 40 | issue = 4 | pages = 741–754 | date = November 2022 | pmid = 36270688 | doi = 10.1016/j.ncl.2022.06.001 }}</ref>

In the United Kingdom, it is estimated that 40–60% of deaths are possibly preventable.<ref name="National Clinical Guideline 21_28" /> In the developing world, many deaths are due to untreated epilepsy leading to falls or status epilepticus.<ref name=Poor2012/>