Epilepsy

Some people experience a warning sensation, called an aura, before one of the following types of partial seizure begins:

Simple Partial Seizures

These seizures begin from a small area in your brain and don’t result in loss of consciousness. They may cause uncontrolled shaking of an arm, leg, or any other part of your body; alter emotions; change the way things look, smell, feel, taste, or sound; or cause speech disturbance.

Complex Partial Seizures

These seizures originate in a localized region of the brain, often starting out small. They alter consciousness and usually cause memory loss (amnesia). They can cause staring and non-purposeful movements, such as repeated hand rubbing, lip smacking, posturing of your arm, vocalization, or swallowing. After the seizure ends, you may be confused or sleep for a few minutes and may be unaware you had the seizure. Temporal lobe seizures are the most common type of complex partial seizures.

Secondarily Generalized Seizures (Partial Seizures with Secondary Generalization)

These seizures occur when simple or complex seizures spread to involve your entire brain. They may begin as a complex partial seizure with staring and non-purposeful movements. The seizure then becomes more intense, leading to generalized convulsions characterized by stiffening and shaking of your extremities and your body.

Absence (Petit Mal Seizures)

Episodes of this condition involve staring, slight body movements, and brief moments of unawareness. They’re usually brief, and typically no confusion or sleepiness occurs when the seizure is over.

Myoclonic Seizures

Seizures are usually manifested by sudden (or sometimes rapid) contractions of the arms and legs They typically affect only one side of your body but may affect both sides. Myoclonic seizures may last only a short time from less than a second for single jerks to a few seconds for repeated jerks.

Atonic Seizures

Commonly referred to as drop attacks, these seizures involve an abrupt collapse or fall. After a few seconds, you regain consciousness and are able to stand and walk.

Generalized Tonic-Clonic (Grand Mal Seizures)

The most intense of all types of seizures, are characterized by a loss of consciousness, body stiffening and shaking, and sometimes tongue biting or loss of bladder control. After the shaking subsides, a period of confusion or sleepiness usually occurs, lasting for a few minutes to a few hours.

Descriptions of your past seizures from yourself or others who have observed your seizures may help your doctor identify the type and cause of your problem. Your physician may also need to know about your current and past medical conditions and how they’ve been treated.

A neurologic examination may include testing your reflexes, muscle tone and strength, the function of your senses, and your gait, posture, coordination, and balance. Your physician may also inquire about your cognitive abilities, logical reasoning skills, and memory recall.

Your doctor may want to take samples of your blood to be tested for chemical imbalances that may be the cause of your seizures.

This procedure records the electrical activity of your brain. An EEG helps determine what type of seizures or epilepsy you have and from which part of the brain seizures may start. During the procedure, which takes about a half-hour, you lie down. Between 16 and 30 small electrodes may be attached to your scalp with paste or an elastic cap.

To get the most accurate results, you need to stay still throughout the test. You might be asked at certain times to take deep and steady breaths for a couple of minutes or look at a patterned board. At times a light may be flashed in your eyes. These activities are designed to activate your brain’s electrical activity as seen on EEG. Electrodes are placed on your head to capture electrical impulses from your brain and transmit them to a machine, which records the activity and displays your brainwaves in the form of a moving graph digitally on a computer screen.

A CT scan produces detailed cross-sectional images of your brain. The images may reveal abnormalities in brain structure, including tumors, cysts, strokes, or tangled blood vessels.

An MRI scan uses a powerful magnetic field and radio waves to produce images of your brain. Like CT scans, MRI images may reveal abnormalities in brain structure.

Through the use of a single antiepileptic drug, many people with epilepsy can experience freedom from seizures. Medication can be a great help to some, working to reduce the frequency and severity of seizures. Over half of the children with epilepsy are able to discontinue the use of their medications and experience a seizure-free lifestyle after their symptoms have been successfully managed. After two or more years without seizures, many adult patients can stop taking their medication.

Determining the correct medication and dose may not be an easy task. It might take more than one drug, or trying several different drugs until the right one is found. Medications available for the treatment of seizures include phenytoin (Dilantin, Phenytek), carbamazepine (Carbatrol, Tegretol), valproic acid (Depakene), Divalproex (Depakote), levetiracetam (Keppra), gabapentin (Neurontin), phenobarbital, ethosuximide (Zarontin), clonazepam (Klonopin), lorazepam (Ativan, Lorazepam Intensol), diazepam (Diastat, Valium), primidone (Mysoline), oxcarbazepine (Trileptal), lamotrigine (Lamictal), topiramate (Topamax), felbamate (Felbatol), tiagabine (Gabitril) and zonisamide (Zonegran).

Taking any of these medications can have some side effects, such as mild fatigue, feeling lightheaded, and possible weight gain. The more severe side effects of a certain condition or medication could be depression, rash, poor coordination, speech impairment, and extreme tiredness. Discuss any of these side effects with your doctor as soon as possible. People with epilepsy often take these medications for an extended period of time without any major side effects. Ask your doctor to explain these issues to you when you receive the prescription.

To ensure the most effective seizure control, always take the medication in accordance with your doctor’s instructions. Some seizure medications increase the risk of birth defects, so if you’re a woman with epilepsy tell your doctor if you’re considering becoming pregnant.

Some people with epilepsy have seizures that medications can’t control because the drugs either cause intolerable side effects or don’t provide satisfactory seizure control. In such cases, surgery may be an option.

Surgery is most commonly done when seizures occur in the side regions (temporal lobes) or the front regions (frontal lobes) of the brain. Surgery is rarely an option if you have seizures that start in several areas of the brain or if you have seizures originating from a region of the brain that contains vital brain functions.

During the procedure, your surgeon makes an incision in your scalp and removes a piece of the skull bone. Using electrical recordings that monitor brain activity, the surgeon cuts into or removes the area of the brain that’s causing the seizures. After surgery, many people continue to need some medication to help prevent seizures.

Each person who has epileptic seizures experiences them in a different way. Many people gain complete control of seizures as soon as they begin treatment. Other people take longer to find the right treatment regimen, and some people may never have complete seizure control.

As is the case with other chronic conditions, having epilepsy may cause you to experience emotional or psychological stress. The stress may be due to personal difficulties in adjusting to epilepsy. You may have to give up some of your independence for a period of time, including driving. You may also encounter stressful relationships with family and friends because of your condition. Following these tips may help you cope with your condition:

Know What to Expect

Find out everything you can about your condition and how to treat it. The more you know, the more active you can be in your own care.

Be Proactive

Although you may feel tired and discouraged, don’t simply let others including your family or your doctor make important decisions for you. Take an active role in your treatment.

Maintain a Strong Support System

Having a support system can help you cope with any issues and anxieties that might occur. Although friends and family can be your best allies, the concern and understanding of a formal support group or others coping with epilepsy also may be helpful. Support groups also can be a good source of practical information. You may find you develop deep and lasting bonds with people who are going through the same things you are.

Set Reasonable Goals

Setting goals helps people gain control of their lives by providing a clear objective and direction to focus on. But be realistic don’t choose goals you can’t possibly reach. It may take time to get your condition under control, so be patient.

Take Time for Yourself

Eating nutritionally, staying active, and getting enough restful sleep. Also, plan ahead for the times when you may need to rest more or limit what you do.

Stay Active

Receiving the diagnosis of epilepsy doesn’t mean you have to stop doing the things you enjoy or normally do. You may have to modify activities such as driving, but you can still lead a full and active life.