Epilepsy is a neurological disorder that causes seizures and unusual behavior. We’re spreading epilepsy awareness because anyone can develop it, and numbers are staggering. Worldwide, 65 million people have epilepsy, of which, 3 million live in the United States, where 150,000 new cases are diagnosed each year. Let’s begin by saying that seizure is not synonymous with epilepsy—having a single seizure does not mean you have epilepsy, but having at least two episodes might point to an epilepsy diagnosis.
Seizure Symptoms and Types
Epilepsy occurs when there is abnormal activity in the brain—and these are the signs and symptoms that people usually experience:
- Staring spell
- Uncontrollable movements
- Loss of consciousness
- Fear, anxiety, déjà vu
Symptoms vary depending on the type of seizure. Seizures are classified as either focal or generalized, based on how the abnormal brain activity begins.
Focal (partial) seizures
Focal seizures occur when there is abnormal activity in just one area of your brain. These seizures are divided into two sub-categories:
- Focal seizures without loss of consciousness: They may alter emotions and cause involuntary movements. Symptoms include alterations to sense of taste, smell, sight, hearing, or touch, dizziness, tingling and twitching of limbs.
- Focal seizures with impaired awareness: They cause loss of consciousness or awareness. Symptoms include staring blankly, unresponsiveness, and performing repetitive movements.
Generalized seizures occur when all areas of the brain perform abnormal activities. These seizures are divided into six sub-categories:
- Absence seizures: They often occur in children. Symptoms include staring into space or subtle body movements such as eye blinking and brief loss of awareness, in some cases.
- Tonic seizures: They cause stiffening of your muscles, especially in your back, arms, and legs—you might fall to the ground.
- Atonic seizures: They are similar to tonic seizures because they affect the muscles, causing loss of control—you might collapse or fall.
- Clonic seizures: They cause jerking muscle movements and usually affect the neck, face, and arms.
- Myoclonic seizures: They cause sudden brief jerks or twitches of arms and legs.
- Tonic-clonic seizures (grand mal seizures): They are the most serious type of seizure and cause sudden loss of consciousness. Other symptoms include stiffening of the body, shaking, loss of bladder or bowel control, and biting of the tongue.
What causes a seizure? For half the people with epilepsy, causes remain unknown, but for the other half, doctors have found the following possible causes.
Genes: When epilepsy runs in families, it’s likely that genes are responsible for this condition—there may be as many as 500 genes that relate to epilepsy. If you have a family history of epilepsy, you may be at increased risk of developing a seizure disorder. It should be noted that the risk of inheriting the condition is fairly low—most parents with epilepsy do not have children with epilepsy.
Head traumas: Head traumas can be the result of traumatic episodes such as car accidents. Traumatic brain injuries can put you at risk of developing epilepsy.
Brain conditions: Brain conditions such as brain tumors or strokes can cause epilepsy—stroke is a leading cause of epilepsy in adults older than age 35.
Developmental disorders: Epilepsy might be connected to developmental disorders, such as autism.
Infectious diseases: Infectious diseases, such as meningitis, AIDS, and viral encephalitis, can cause epilepsy.
Other diseases: Serious illness, vascular diseases, dementia, and Alzheimer’s disease can cause epilepsy.
Prenatal injury: Babies in the womb are sensitive to brain damage that can be caused by several factors related to infections in the mother, poor nutrition, and lack of oxygen. These conditions may result in epilepsy.
Keep in mind that epilepsy does not affect your ability to have children, but some epilepsy medications can affect your baby in the womb. If you have epilepsy and are considering having a baby, talk to your doctor before becoming pregnant or as soon as you become pregnant to evaluate the best options for your health and the health of your baby.
Seizures can be triggered by a variety of factors, and most of the time they are due to a combination of events. The most common triggers are:
- Lack of sleep
- Bright lights
- Caffeine, alcohol
- Medicines, drugs
- Specific foods
It’s crucial to identify seizure triggers, and the best way is to keep a seizure journal. After each episode, note the following:
- Day and time
- Unusual stressors
- Food you ate
- Level of fatigue
- How you slept the night before
Use your seizure journal also to determine if treatments are working—and bring the journal with you when you visit the doctor.
Most people are able to manage epilepsy. The treatment depends on the symptoms and how well you respond to therapy. Epilepsy treatment options include the following.
Anti-epileptic, also called anti-seizure drugs, can eliminate seizures or reduce the number of seizures you have. Finding the right medication and dosage can be difficult—your doctor will consider your general health, frequency of seizures, age, and other factors. Anti-seizure medications may have some side effects such as fatigue, dizziness, weight gain, and skin rashes. Severe side effects such as depression and inflammation of certain organs may also occur. Make sure you take medications exactly as prescribed and notify your doctor if you notice unusual changes in your mood and behavior. Between 60-70% of people with epilepsy respond satisfactorily to the first anti-epilepsy drug they try. About 50% can stop taking medications after two to five years without a seizure.
One of the most common therapies used is the vagus nerve stimulator. This device is placed under the skin on the chest (similar to a pacemaker) and electrically stimulates the nerve that runs through your neck. This can usually reduce seizures by 20 to 40%. People who use this therapy might experience side effects such as throat pain, hoarse voice, shortness of breath, or coughing.
Some people who do not see improvements taking medications benefit from a ketogenic diet, which is high in fat and low in carbohydrates. Usually, the body uses glucose (a form of sugar) from carbohydrates for its energy source. In a ketogenic diet, chemicals called ketones are made when the body uses fat for energy (this is called ‘ketosis’)—these chemicals help reduce seizure, and in some cases, can eliminate them. The ketogenic diet is also rich in amino acids, which are essential for our survival.
The area of the brain that causes seizure activity can be removed or altered. Doctors usually perform surgery when tests show that your seizures originate in a small, well-defined area of your brain and the area does not interfere with vital functions such as speech, language, motor function, vision, or hearing. In rare cases, surgery for epilepsy can cause complications such as permanently altering your thinking (cognitive) abilities. Talk to your surgeon about success rates and possible complications before making a decision.
Potential Future Treatments
Research into new forms of therapy for epilepsy is ongoing. One treatment that may become available in the future is deep brain stimulation, a procedure in which electrodes are implanted into your brain and a generator is implanted in your chest. The generator sends impulses to the brain to help reduce seizures.
Epilepsy Awareness Month is in November. To help spread awareness and decrease discrimination against this prevalent condition, visit the Epilepsy Foundation online, and find out how you can become involved.