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When a cluster of the human brain’s 100 billion neurons starts firing in synchronous bursts, the result is a seizure, one of the most common neurological conditions. 1 in 95.61 adults suffer from repeated seizures, known as epilepsy. Generalized seizures, those that spread throughout the entire brain, cause anything from blank stares to muscle convulsions and loss of consciousness, while partial seizures invoke weird smells, nausea, dejà vu, and hallucinations.

Forty percent of cases are “idiopathic,” meaning either hereditary or without apparent cause. These cases usually develop when a person is young, between ages 5 and 20, but can start at any age. Other epilepsies arise from nervous system infections, such as meningitis or encephalitis. Any damage to the brain can provoke seizures. For example, stroke is the most common cause of epilepsy in the elderly.

Head injuries, such as the one 10-year-old future abolitionist Harriet Tubman suffered, are another cause of epilepsy. When one of her overseers hurled a 2-pound iron weight at a fleeing slave, young Harriet took the blow to her skull instead, and suffered lifelong headaches and seizures. Today, neurologists would probably diagnose her with temporal lobe epilepsy, taking into account the seizures and her post-injury religious visions. For treatment, they might surgically remove part of her brain to stop the seizures. Surgery is becoming a safer treatment for the 40% of epilepsy suffers whose medication either fails to stop the seizures or causes intolerable side effects.

Neurologists could instead opt for Vagus Nerve Stimulation and implant a battery-powered device under her chest skin. The small stimulator delivers mild electrical signals to the vagus nerve, the longest nerve in the body, to disrupt the oncoming seizure.

Epilepsy can be fatal. One such case was President George Washington’s stepdaughter, who was diagnosed with epilepsy at age 12. In June of 1773, she rose from the dinner table and dropped dead. Today, her death would most probably be pegged as sudden unexpected death, or SUDEP. Such mortalities account for 50% of deaths among patients with treatment resistant epilepsy. The risk of sudden unexpected death is 24 to 40 times higher in epilepsy patients than in the general population.

As with all disorders, some patients deal with deeper impairment than others, but for those with access to contemporary treatments and surgical techniques, 80% of people can control their seizures.