Learning About Epilepsy and Seizures

About Epilepsy

What you need to know

When it comes to epilepsy, knowledge is power. Whether you’ve had epilepsy for years or you are newly diagnosed, the more you know, the more you can do to try to control epilepsy and live life on your terms.

What is epilepsy?

Epilepsy is a neurological disorder sometimes called a seizure disorder because seizures are the primary symptom. But a single seizure is not necessarily a sign of epilepsy. Tests such as brain scans can determine if a person has epilepsy.

What is a seizure?

A seizure is the result of a change in the normal electrical activity in the brain. Depending on the type of seizure—there are many—it can last for a few seconds or minutes, manifesting in various ways, with symptoms ranging from rapid blinking and staring at nothing in particular to loss of consciousness, falling, and muscle jerks. There are two major categories of seizure: generalized and partial onset, also known as focal.

1. Generalized seizures happen when both sides of the brain are affected. Some examples include:
   • Absence seizures (also known as petit mal seizures), which can cause rapid blinking or staring into space
   • Tonic-clonic seizures (also known as grand mal seizures), which can cause involuntary crying out, loss of consciousness, falling, and convulsive muscle jerks or spasms
2. Partial onset seizures happen when one area of the brain is affected. According to the National Institute of Neurological Disorders and Stroke, about 60% of people with epilepsy experience partial onset seizures, which include:
   • Simple partial seizures, which can cause twitching or the sense of an odor or taste that’s not actually there
   • Complex partial seizures, which can impair consciousness so a person may appear dazed or confused, possibly unable to respond to others for a few minutes
   • Secondarily generalized partial seizures, which can occur when a partial seizure spreads to both sides of the brain, becoming a generalized seizure

Who gets epilepsy?

People with epilepsy experience repeated seizures. According to the Centers for Disease Control and Prevention (CDC), about 2.9 million people in the United States are affected by epilepsy. And according to a 2011 study, one in 26 people will develop epilepsy in their lifetime. Epilepsy is a brain condition that causes seizures, which are disruptions of the electrical communication between neurons. Following tests, a person is said to have epilepsy after he or she has experienced two or more unprovoked seizures, at least 24 hours apart.

What is the difference between seizures and epilepsy?

Seizures are the main symptom of epilepsy, but having a seizure once does not necessarily mean a person has epilepsy. A single seizure can result from other medical problems, such as high fevers, low blood sugar, very high blood sugar in diabetics, an imbalance of salt in the blood, eclampsia during or after pregnancy, and sleep deprivation.

Causes

What causes epilepsy?

The cause of epilepsy is unknown in as many as two-thirds of people affected, according to the CDC. This is sometimes called cryptogenic or idiopathic epilepsy. For others the cause of their epilepsy is clear: traumatic brain or head injury, brain tumors, birth defects, or stroke, for example.

The different causes of epilepsy can happen at any stage of life.

• A birth defect or brain injury during birth may lead to seizures in childhood
• A mutation in a gene that helps to break down carbohydrates in brain cells causes Lafora disease, a form of myoclonic epilepsy that begins in childhood
• Certain infectious diseases, such as viral encephalitis, can disrupt normal brain activity and lead to changes that make seizures more likely
• Conditions that deprive the brain of oxygen, such as stroke and heart attack, are common causes of epilepsy in the elderly

What may trigger a seizure in someone with epilepsy?

Many things that trigger seizures in people with epilepsy are considered part of everyday life. These include:

• Stress
• Lack of sleep
• Hormone changes (such as those that occur during a woman’s menstrual cycle)
• Drinking alcohol
• Dehydration
• Missing meals
• Overdoses of medicine or exposure to other drugs
• Flashing lights or other visual stimulation

Treatment

Are there treatments for epilepsy?

People with epilepsy work closely with neurologists and epileptologists to find the right treatment that will help them achieve better seizure control. There are multiple treatments that may help reduce seizures.

What are my treatment options?

There are a number of treatments for epilepsy, including medication, surgery, and special diets. One option is vagus nerve stimulation, which is accomplished by an electrical device implanted under the skin or on the skin to send signals to a nerve in the neck. Others may benefit from the strict high-fat, low-carbohydrate ketogenic diet.

How can I remember to take my epilepsy medications?

The most common epilepsy treatment is antiseizure medication. Taking your medications properly is very important in treating your epilepsy. It is important not to skip doses and to establish a schedule you can remember and stick with. A few tips for sticking with your epilepsy medication schedule are:

Whether you’re newly diagnosed or someone who has been living with seizures for some time, knowledge is crucial for successful epilepsy treatment. By knowing the facts, talking to your neurologist or epileptologist, and connecting with others with epilepsy, you can work toward seizure control and to living your life on your own terms.

Diagnosis

If you or your loved one has had a seizure, a correct diagnosis is essential to good health. After determining the kind of seizure experienced, and how it relates to any other kind of underlying medical condition, a treatment plan should begin as soon as possible. But remember, the physician is treating the whole person, so the seizure could very likely be related to another condition that needs treatment.

How is epilepsy diagnosed?

The first step is an interview with a good neurologist or epileptologist, a neurologist who specializes in epilepsy. The neurologist’s first tool in diagnosing epilepsy is a thorough medical history of the patient, including family history of seizures, if any; an observer’s account of what the seizure looked like; and an account of what happened just before it began.

You may be given blood tests, an electroencephalogram (EEG), a computed tomography (CT) scan, or a functional magnetic resonance imaging (fMRI) scan. These are just some of the tests that can be helpful in epilepsy diagnosis.

Once epilepsy is diagnosed it is important to maintain a relationship with a neurologist or epileptologist.