Epilepsy is a neurological disorder. It’s also classified as
a seizure disorder that affects the nervous system. A seizure is a disturbance
of the electrical activity in your brain. Not everyone with epilepsy has the
same type of seizure and it may affect people differently.
Symptoms of Epilepsy
There are multiple kinds of epilepsy, and the two types of
epileptic seizures are partial and generalized.
Partial seizures, also known as focal seizures, occur in a
specific part of the brain and may only affect part of the body. Symptoms of
partial seizures include:
- jerky movements
- tingling or dizziness
- repetitive motions
- staring or confusion
- emotional changes
Generalized seizures occur all over the brain and can affect
the entire body. Symptoms of general seizures include:
- twitching motions
- falling down
- loss of consciousness
- biting the tongue
- loss of bladder control
- stiffening of the body
Risk Factors and Causes
In many people the cause of epilepsy is not known. The Centers for Disease
Control and Prevention (CDC) estimates that nearly two-thirds of epilepsy
diagnoses have no known cause. Children are more likely than adults to have
epilepsy with no known cause. There are some risk factors that may play a part
in developing epilepsy, but a person can have risk factors and never develop
the condition. These include:
- head injury or traumatic brain injury
- brain tumor
- Alzheimer’s disease
- lack of oxygen at time of birth
- brain infection like meningitis
- hardening of the arteries of the brain
A family history can be a risk factor for developing
epilepsy, but it’s not known how the condition gets passed genetically.
states that about 2.3 million adults and more than 467,700 children in the
United States are living with epilepsy. Approximately 150,000 new cases are
diagnosed each year.
An accurate diagnosis is crucial. Without an accurate
diagnosis, treatment will be ineffective. The first step a doctor needs to take
is to figure out whether the symptoms you describe are due to a seizure. If it is
determined that the symptoms are consistent with a seizure, the type of seizure
and the cause need to be identified.
The doctor will ask a variety of questions to get a detailed
medical history. This can help the doctor rule out certain conditions that are
not epilepsy and look for any other underlying medical issues. You or a family
member will be asked about what happened before, during, and after a seizure.
Lab tests that are typically done include a complete blood
count (CBC). This helps to see if there is an infection or an abnormality in
electrolytes, as well as certain genetic disorders or problems with the kidneys
that may be causing your seizures. A toxicology screen might also be done to
see if there are any drugs or poisons in your blood that can cause seizures.
Lumbar puncture can be performed to rule out infections. This involves
obtaining cerebrospinal fluid from your lower back by inserting a needle
between certain bones of your spine.
According to Cedars-Sinai
Medical Center, the most important diagnostic test for epilepsy is an
electroencephalogram (EEG). This test records the brain’s electrical activity
and monitors for any abnormal spikes or patterns. Various kinds of epilepsy can
be diagnosed based on the patterns. Video EEG can also be used during seizures
to document what happens in the brain before, during, and after a seizure. Magnetic
resonance imaging (MRI) and computed tomography (CT) scans can help identify
where in the brain the abnormal activity is. These imaging tests can also help
rule out tumors or other abnormalities.
Treatment of Epilepsy
Once an accurate diagnosis of epilepsy is made, treatment options
are explored. Drugs are an important part of epilepsy treatment. Antiepileptic
drugs, or anticonvulsants, are effective at controlling seizures in many
patients. There are many different kinds of seizure medications including:
- primidone (Mysoline)
- topiramate (Topamax)
- gabapentin (Neurontin)
- clonazepam (Klonopin)
Each one carries various side effects and risks. It’s best
to talk with your doctor about which medication is best for you. You might have
to try different dosages or different medications before finding one that works
Surgery might be an option for people who don’t respond to
medication. Typically this is only done after at least two different drugs have
been tried, and with people whose seizures have been uncontrolled for at least one
Dietary changes can help control epilepsy. Your doctor or
nutritionist may prescribe a ketogenic diet. This is a diet that’s high in fat
and low in carbohydrates.
Each person is different and what works for one person may
not work for another. Talk with your doctor about your symptoms and what
treatments have worked and what haven’t. They can then construct a treatment
plan tailored to your situation.
Doctors Who Treat Epilepsy
When diagnosed with epilepsy, it’s normal to have a
treatment team rather than just one single provider. Doctors who help treat
- family practitioners
Primary care doctors are usually the ones who see patients
showing the first signs of the condition. Neurologists are doctors who
specialize in the brain. Within that field, some neurologists concentrate on
and specialize in epilepsy. This specialty is called epileptology. If your
epilepsy is especially problematic or you need special care, you might see an
epileptologist or go to an epilepsy center.
Epilepsy can usually be controlled with treatment and an
individual can live a full, symptom-free life. There are always possible side
effects with each medication, which may lead to complications. Ask your doctor
about the specific medications you are taking, as well as what the risks are.
If a person with epilepsy has a major seizure and falls,
there is the danger of hurting their head and possibly causing a life-threatening
injury. Status epilepticus is the occurrence of many prolonged seizures
occurring successively. This condition can be life threatening.
Sudden death in individuals with epilepsy is rare, but does
happen. This is more likely in those with major seizures that are not well
controlled. It can also happen in the general population of those without
There is no way to prevent epilepsy from developing. Once it’s
diagnosed, prevention and control of seizures is important. This is done
through diet, surgery, medications, or other treatment options or lifestyle
modifications that you and your doctor have discussed.
Epilepsy can be a frightening condition. This is especially
true in the beginning when a diagnosis and treatment plan have not been
established. With appropriate care and treatment, you can live a productive and
full life with epilepsy. Research and information is available on various
epilepsy websites, and your doctor can provide you with more resources.