Approximately 2 million people in the United States have epilepsy, a chronic disorder of the brain that causes a tendency to have recurrent seizures. Two or more seizures must occur before a person can receive the diagnosis of epilepsy, also known as a seizure disorder. It’s not uncommon for children to have a single seizure, and an estimated 5 percent to 10 percent of the population will experience a seizure at some time in their life.
Seizures occur when there’s a sudden change in the normal way your brain cells communicate through electrical signals. During a seizure, some brain cells send abnormal signals, which stop other cells from working properly. This abnormality may cause temporary changes in sensation, behavior, movement or consciousness.
The onset of epilepsy is most common during childhood and after age 65, but the condition can occur at any age. Treatments may be able to leave you free of seizures, or at least reduce their frequency and intensity.
Because abnormal brain cell activity causes seizures, having a seizure can result in the sudden occurrence of any activity that’s coordinated by your brain. This can include slight temporary confusion, complete loss of consciousness, a staring spell, muscle spasms, or uncontrollable, jerking movements of the arms and legs. Seizures originating in your brain’s temporal lobe can be associated with a sense of deja vu, anxiety and panic, or simply an uneasy sensation in your stomach, which can be followed by loss of consciousness.
Signs and symptoms may vary depending on the type of seizure. Most people with epilepsy experience the same type of seizure, with similar symptoms, each time they have a seizure, but others may experience a wide range of types and symptoms.
Doctors classify seizures as either partial or generalized, based on how the abnormal brain activity begins. When seizures appear to result from abnormal activity in just one part of the brain, they’re called partial seizures. When seizures seem to involve most or all of the brain, the seizures are called generalized.
Both classifications are broken up further into smaller, more specific categories:
Some people experience a warning sensation, called an aura, before one of the following types of partial seizure begins:
The onset of epilepsy can often be traced to an accident, disease or medical trauma such as a stroke that injures your brain or deprives it of oxygen, often causing a small scar in your brain. In rare occasions, epilepsy may be caused by a tumor in your brain. However, in many cases there’s no identifiable cause for the disease.
Epilepsy isn’t a mental disease, although mental health can influence the control of seizures in epilepsy. Epilepsy doesn’t cause psychiatric problems or mental retardation, but people with epilepsy may also be afflicted with those conditions.
Research suggests that genetic abnormalities contribute significantly to epilepsy. If you have a family history of the disease, you may be at increased risk.
Head injuries are responsible for many cases of epilepsy. You can reduce your risk by always wearing a seat belt while riding in a car and by wearing a helmet while bicycling, skiing, riding a motorcycle, or engaging in other activities with a high risk of head injury.
Stroke and other diseases that affect your vascular system can lead to brain damage that may trigger epilepsy. You can take a number of steps to reduce your risk of these diseases, including limiting your intake of alcohol, following a healthy diet, managing your weight, exercising regularly and avoiding cigarettes.
Other epilepsy risk factors include:
Because the possible causes of seizures are many, doctors may need to ask detailed questions and perform several tests to diagnose epilepsy, including:
Most people with epilepsy can become free of their seizures by using a single antiepileptic drug. For others, medication can make seizures less frequent and less intense. More than half of children with epilepsy whose seizures are controlled by medications can eventually stop their medications and live a seizure-free life. Many adults also can discontinue medication after two or more years without seizures.
Finding the right medication and dosage can be complex. 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).
All of these medications have some side effects, which may include mild fatigue, dizziness and weight gain. More severe side effects include depression, skin rashes, loss of coordination, speech problems and extreme fatigue. Discuss any of these side effects with your doctor as soon as possible. Many people with epilepsy use these medications for years without significant problems. Ask your doctor to explain these issues to you when you receive the prescription.
To achieve the best seizure control possible, take medications exactly as prescribed. 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:
Doctorsolve Healthcare Solution site strives to provide you with timely, accurate information, which is not intended for diagnosis or treatment.