Epilepsy

What is epilepsy?

Epilepsy is a neurological condition that can induce recurring, unprovoked seizures. For people with epilepsy, brain activity becomes abnormal and, in addition to seizures, can cause unusual behavior, sensations, and loss of awareness.

A seizure is defined as a rush of unusual electrical activity in the brain. Doctors will make an epilepsy diagnosis after two or more seizures with no other discernible cause.

The two most common types of seizures are:

• Focal seizures
• Generalized seizures

According to the Centers for Disease Control (CDC) approximately 50 million people around the world have epilepsy, including 3.5 million people just in the United States.

What causes epilepsy?

Every case of epilepsy is different, including what causes it. Some cases have no identifiable cause. Otherwise, doctors can typically identify the cause as brain trauma, genetic predisposition, autoimmune disorders, infectious diseases, or metabolic issues.

Epilepsy has different causes based on how old you are. Read about some common causes of epilepsy by age below.

• Newborns: lack of oxygen during birth, brain malformations, metabolism issues, maternal drug use, bleeding in the brain, low levels of blood sugar, blood calcium, or blood magnesium
• Infants and Children: infections, brain tumor, fever
• Children and Adults: genetic factors, progressive brain disease, congenital conditions, head trauma
• Older Adults: Alzheimer’s disease, stroke, head trauma

What are symptoms of epilepsy?

Seizures are the most common symptom of epilepsy. However, symptoms present differently for different people and which type of seizure they are having. As mentioned above, there are two main types of seizures: focal and generalized.

Focal aware seizures, previously known as simple partial seizure, do not cause the person to lose consciousness. Symptoms of a focal aware seizure often include dizziness, limb twitching and tingling, and/or affected sense of sight, hearing, smell, taste, or touch.

Focal unaware seizures, previously known as complex partial seizures, cause the person to lose consciousness. Symptoms of a focal unaware seizure include having a blank stare, unresponsiveness, and performing repetitive movements.

By contrast, generalized seizures affect the whole brain. Different types of generalized seizures include:

• Tonic seizures: Tonic seizures cause immediate stiffness in the leg, arm, or trunk muscles.
• Atonic seizures: Atonic seizures cause a loss of muscle control. This loss of muscle control can cause a sudden fall, earning this seizure the name “drop seizure.”
• Tonic-clonic seizures: Previously known as grand mal seizures, symptoms of a tonic-clonic seizure include shaking, loss of bladder or bowel control, biting of the tongue, stiffening of the body, and loss of consciousness.
• Clonic seizures: Clonic seizures produce jerky, repeated muscle movements in the neck, face, and arms.
• Myoclonic seizures: Myoclonic seizures cause quick, spontaneous muscle twitching in the legs and arms.
• Absence seizures: Previously known as petit mal seizures, an absence seizure can cause a brief loss of awareness, a blank stare, and repetitive movements.

Are there any risk factors or groups for epilepsy?

Some risk factors and groups increase your chance of developing epilepsy, including:

• Family history: A family history of epilepsy can increase your risk of developing the condition.
• Age: Children and older adults are most likely to develop epilepsy. That being said, the condition can occur at any age.
• Dementia: Having dementia can increase the risk of epilepsy for older adults.
• Brain infections: Brain infections, like meningitis, can cause inflammation in the brain and spinal cord. This inflammation increases your risk of epilepsy.
• Head injuries: Head injuries can cause epilepsy. Reduce your chances of getting a head injury by using a seat belt when riding in a car and using a helmet when skiing, riding a motorcycle, bicycling, and doing other activities that have a high risk of head injury.
• Seizures as a child: Some high fevers in childhood are associated with seizures. Children who have seizures as a result of a high fever usually won’t develop epilepsy. A child’s risk of epilepsy rises if they have a nervous system condition, long fever-associated seizure, or family history of epilepsy.
• Stroke and other vascular diseases: Stroke and other diseases that impact blood vessels can cause brain damage and, ultimately, epilepsy. Reduce your chances of getting a vascular disease by reducing alcohol intake, quitting smoking, exercising regularly, and eating a healthy diet.

How is epilepsy diagnosed?

See a doctor right away if you suspect you have epilepsy. Your doctor will review your symptoms and medical history to determine which tests will help make the best diagnosis. You will likely undergo a neurological examination to assess your mental functioning and motor abilities.

In order to make an epilepsy diagnosis, your doctor will have to rule out other conditions that cause seizures. A complete blood count can reveal:

• Kidney and liver function
• Signs of infectious diseases
• Blood glucose levels

An electroencephalogram (EEG) can help diagnose epilepsy. A doctor will place electrodes on your scalp to identify abnormal patterns in your brain’s electrical activity. Imaging tests, including a CT scan, MRI, positron emission tomography, or single-photon emission computerized tomography, can help identify tumors or other abnormalities that induce seizures.

How is epilepsy treated?

Epilepsy treatment depends on the severity of your symptoms, your overall health, and how well you respond to therapy. Epilepsy treatment can include:

• Antiepileptic drugs: Anticonvulsant or antiseizure drugs help reduce the number of seizures. Though this type of medication is not a cure for epilepsy, an antiepileptic drug can eliminate seizures completely for some people. Your doctor will likely prescribe a low dose at first and adjust as necessary. Rare side effects include inflammation of the liver and other organs, as well as depression.
• Ketogenic diet: Some people’s bodies will not respond to medications. In this case, a ketogenic diet might relieve some epilepsy symptoms. The ketogenic diet consists of low carbohydrate and high fat intake.
• Vagus nerve stimulator: A vagus nerve stimulator is a device that requires surgery to place under the skin of the chest. This device will electrically stimulate the nerve that runs through the neck to prevent seizures.
• Brain surgery: Depending on the severity of your epilepsy, a doctor could recommend removing or altering the part of the brain that causes seizures.

What are lifestyle changes that could help with epilepsy?

There are some lifestyle changes that could help with epilepsy, including:

• Eat a well-balanced diet. Try to avoid long periods of time without food. Eating when you take your medication can reduce stomach issues as a result of your medication.
• Avoid places that have bright flashing lights and noises. These sudden sensory experiences can trigger a seizure.
• Get enough sleep. Fatigue can cause seizures because disrupted sleep makes the brain more prone to misfiring.
• Avoid drugs and alcohol. Even small amounts of drugs and alcohol can trigger seizures for some people with epilepsy.
• Exercise regularly. Exercise can reduce your risk of seizure. Check with your doctor before starting a new exercise, as some exercises can trigger seizures.

Should you see a doctor for epilepsy?

If you have a seizure, you should see a doctor immediately. Depending on the severity, you can manage epilepsy by creating a treatment plan with your doctor. The earlier you get treatment, the better. Early treatment can reduce seizures and your chances of developing serious health complications.

What is the outlook for people living with epilepsy?

Epilepsy is a chronic condition that will impact your everyday life. Seizures occur at random, which means that even mundane activities can be dangerous to your wellbeing. You might experience a loss of independence.

There is no cure for epilepsy. If medication does not reduce your seizure frequency, your doctor might recommend surgery or vagus nerve stimulation. Finding the right treatment can significantly improve your quality of life.

Some ways you can cope with an epilepsy diagnosis include:

• Wearing a medical bracelet so people know you have epilepsy
• Writing down when you have seizures to identify potential triggers
• Teaching your loved ones how to identify a seizure and what they should do when one occurs
• Joining a support group for people with epilepsy