What is Epilepsy?
Epilepsy is a medical condition that produces seizures affecting a variety of mental and physical functions. It’s also called a seizure disorder. When a person has two or more seizures, they are considered to have epilepsy.
A seizure happens when a brief, strong surge of electrical activity affects part or all of the brain. One in 10 adults will have a seizure sometime during their life. Seizures can last from a few seconds to a few minutes. They can have many symptoms, from convulsions and loss of consciousness to some that are not always recognized as seizures by the person experiencing them or by health care professionals: blank staring, lip smacking, or jerking movements of arms and legs.
Types of Seizures
There are many different types of seizures. People may experience just one type or more than one. The kind of seizure a person has depends on which part and how much of the brain is affected by the electrical disturbance that produces seizures. Experts divide seizures into generalized seizures (absence, atonic, tonic-clonic, myoclonic), partial (simple and complex) seizures, nonepileptic seizures and status epilepticus.
Classifying epilepsy by seizure type alone leaves out other important information about the patient and the episodes themselves. Classifying into syndromes takes a number of characteristics into account, including the type of seizure; typical EEG recordings; clinical features such as behavior during the seizure; the expected course of the disorder; precipitating features; expected response to treatment, and genetic factors. Find out more about epilepsy syndromes.
Causes of Epilepsy
Seizures are symptoms of abnormal brain function. With the exception of very young children and the elderly, the cause of the abnormal brain function is usually not identifiable. In about seven out of ten people with epilepsy, no cause can be found. Among the rest, the cause may be any one of a number of things that can make a difference in the way the brain works. Head injuries or lack of oxygen during birth may damage the delicate electrical system in the brain. Other causes include brain tumors, genetic conditions (such as tuberous sclerosis), lead poisoning, problems in development of the brain before birth, and infections like meningitis or encephalitis. Find out more about causes of epilepsy.
Some people who have epilepsy have no special seizure triggers, while others are able to recognize things in their lives that do affect their seizures. Keep in mind, however, that just because two events happen around the same time doesn't mean that one is the cause of the other. Generally, the most frequent cause of an unexpected seizure is failure to take the medication as prescribed. That's the most common trigger of all. Other factors include ingesting substances, hormone fluctuations, stress, sleep patterns and photosensitivity.
Photosensitivity and Seizures
Epilepsy affects more than three million Americans. For about 3 percent of them, exposure to flashing lights at certain intensities or to certain visual patterns can trigger seizures. This condition is known as photosensitive epilepsy.
Diagnosing epilepsy is a multi-step process, usually involving the following evaluations:
- Confirmation through patient history, neurological exam, and supporting blood and other clinical tests that the patient has epileptic seizures and not some other type of episode such as fainting, breath-holding (in children), transient ischemic attacks, hypoglycemia, or non-epileptic seizures.
- Identification of the type of seizure involved.
- Determination of whether the seizure disorder falls within a recognized syndrome.
- A clinical evaluation in search of the cause of the epilepsy.
- Based on all previous findings, selection of the most appropriate therapy.
Types of Treatment:
Most epilepsy medicines are taken by mouth. The doctor's choice of which drug to prescribe depends on what kind of seizure a person is having. Some people experience side effects, others may not. Some people's seizures will respond well to a particular drug while someone else will have seizures that continue. It may take some time to find exactly the right dose of the right drug.
Surgical removal of seizure-producing areas of the brain has been an accepted form of treatment for over 50 years when medicines fail to prevent seizures. However, because of new surgical techniques and new ways of identifying areas to be removed, more of these operations are being done now than ever before, and with greater success.
Vagus nerve stimulation is a type of treatment in which short bursts of electrical energy are directed into the brain via the vagus nerve, a large nerve in the neck. The energy comes from a battery, about the size of a silver dollar, which is surgically implanted under the skin, usually on the chest. Just how it works to prevent seizures is being studied.
The ketogenic diet, which is very high in fats and low in carbohydrates, makes the body burn fat for energy instead of glucose. When carefully monitored by a medical team familiar with its use, the diet helps two out of three children who are tried on it and may prevent seizures completely in one out of three.
In our culture, treatment of medical conditions is based on carefully recorded results in fairly large groups of people. If a treatment is effective for many people under controlled circumstances, it can be expected to work for others. Non-traditional practices are usually not subjected to this kind of evaluation, so there is no scientific proof that they are likely to work. Nevertheless, some people say they feel better, or have fewer seizures, when they use these remedies.
Treatment for Children
Childhood epilepsy is usually treated with seizure-preventing medicines. If the drugs don't work, or the child has a lot of side effects, surgery or the ketogenic diet may be
Epilepsy in Children
Epilepsy is a disorder of the brain.
A child's brain contains billions of nerve cells. They communicate with each other through tiny electrical charges that fire on and off in random fashion. When some or all of these cells suddenly begin to fire together, a wave of electrical energy sweeps through the brain, causing a seizure.
Seizures interfere with the brain's normal functions. They can cause a child to have sudden changes in consciousness, movement, or sensation.
Some people use the term "seizure disorder" instead of "epilepsy" to describe this condition. In fact, both words mean the same thing -- an underlying tendency to experience seizures.
Having a single seizure does not mean a child has epilepsy -- epilepsy is the name for seizures that happen more than once without a known treatable cause such as fever or low blood sugar.
Social Consequences of Epilepsy in Women
Do people with epilepsy have problems socially? Does it affect them psychologically?
Epilepsy is a chronic disorder that may affect how you feel about yourself and your relationship with other people, such as family, friends, or co-workers. It does not automatically mean problems although anyone can have emotional difficulties with self-esteem or relationships. People with epilepsy may be embarrassed or fearful about their seizures and they may have to content with the ignorance and fear of other people. Some people work through these issues on their own, and others may need some help from a nurse or a professional counselor to deal with them effectively.
Genetics and Epilepsy
What is genetics?
Genetics is the study of genes, which are the basic units of heredity. Human beings have many thousands of genes. Each of these genes influences certain traits such as hair color, eye color, blood type, and many other characteristics. People are different with regard to these traits because their genes are different. Children look similar to one or both parents, for example, or have traits similar to their grandparents and other relatives, because of certain genes which have been passed or inherited from one generation to the next.
Menopause and Epilepsy
What does the change of life have to do with my seizure disorder?
Menopause is the time in a woman's life when her ovaries stop working, her menstrual periods stop and the level of sex hormones in her body decreases. We know that because hormones have an effect on brain function, seizure patterns may change in some women as they go through menopause, just as they may at other times of hormonal change.
Seizures in Later Life
If you are a senior citizen, you can probably remember a time when there were no reliable treatments for epilepsy. People did not understand why seizures happened and they were afraid of them. You may remember, as a child, that families often sent people with seizures off to institutions, or kept them at home, isolated from others. And you may have heard it whispered (incorrectly) that epilepsy is a form of mental illness. Find out more about how perceptions have changed.