Epilepsy
Epilepsy is a central nervous system (neurological) disorder in which brain activity becomes abnormal, causing seizures or periods of unusual behavior, sensations, and sometimes loss of awareness. Anyone can develop epilepsy. Epilepsy affects both males and females of all races, ethnic backgrounds, and ages. Seizure symptoms can vary widely. Some people with epilepsy simply stare blankly for a few seconds during a seizure, while others repeatedly twitch their arms or legs. Having a single seizure doesn't mean you have epilepsy. At least two seizures without a known trigger (unprovoked seizures) that happen at least 24 hours apart are generally required for an epilepsy diagnosis.
Causes
- Genetic influence - Some types of epilepsy, which are categorized by the type of seizure you experience or the part of the brain that is affected, run in families. In these cases, it's likely that there's a genetic influence.
- Head trauma - Head trauma as a result of a car accident or other traumatic injury can cause epilepsy.
- Brain conditions - Brain conditions that cause damage to the brain, such as brain tumors or strokes, can cause epilepsy. Stroke is a leading cause of epilepsy in adults older than age 35.
- Infectious diseases - Infectious diseases, such as meningitis, AIDS and viral encephalitis, can cause epilepsy.
- Prenatal injury - Before birth, babies are sensitive to brain damage that could be caused by several factors, such as an infection in the mother, poor nutrition or oxygen deficiencies. This brain damage can result in epilepsy or cerebral palsy.
- Developmental disorders - Epilepsy can sometimes be associated with developmental disorders, such as autism and neurofibromatosis.
- Childhood seizures - Sometimes children have seizures that are caused by factors such as high fevers. These seizures are not epilepsy, but having these types of seizures might increase the risk of developing epilepsy later in life.
- Brain structure abnormalities - Abnormalities in the brain's structure, such as vascular malformations, can cause seizures.
- Dementia - Dementia can cause epilepsy in older adults.
- Metabolic disorders - Metabolic disorders, such as phenylketonuria or porphyria, can lead to seizures.
Signs and Symptoms
- Temporary confusion - A period of confusion and difficulty talking or understanding others.
- Staring spell - A brief period of fixed staring, often mistaken for daydreaming in children.
- Uncontrollable jerking movements - Involuntary movements of the arms and legs that can't be controlled.
- Loss of consciousness or awareness - Fainting or inability to respond to others for a period of time.
- Psychic symptoms - Such as fear, anxiety or déjà vu (the feeling of having experienced a situation before).
- Altered senses - Changes in how things look, sound, smell, taste, or feel.
- Autonomic symptoms - Changes in blood pressure, heart rate, or sweating.
- Cognitive symptoms - Difficulty speaking, inability to understand others, or confusion.
- Emotional symptoms - Sudden feelings of fear, anxiety, or joy that aren't related to the current situation.
- Physical symptoms - Numbness, tingling, or electric-shock-like feelings in parts of the body.
Diagnosis
Neurological Examination
Your doctor will test your behavior, motor abilities, mental function and other areas to diagnose your condition and determine the type of epilepsy you may have.
Blood Tests
Your doctor may take a blood sample to check for signs of infections, genetic conditions or other conditions that may be associated with seizures.
Electroencephalogram (EEG)
This is the most common test used to diagnose epilepsy. In this test, electrodes are attached to your scalp to record the electrical activity of your brain. If you have epilepsy, it's common to have changes in your normal pattern of brain waves, even when you're not having a seizure.
Computerized Tomography (CT) Scan
A CT scan uses X-rays to obtain cross-sectional images of your brain. CT scans can reveal abnormalities in your brain that might be causing your seizures, such as tumors, bleeding and cysts.
Magnetic Resonance Imaging (MRI)
An MRI uses powerful magnets and radio waves to create a detailed view of your brain. Your doctor may be able to detect lesions or abnormalities in your brain that could be causing your seizures.
Treatment Options
Anti-seizure Medications
These medications, also called anti-epileptic drugs (AEDs), can reduce the number and severity of seizures. Many people with epilepsy can become seizure-free by taking one anti-seizure medication, while others may need to take several. The type of medication prescribed depends on the type of seizures, age, and other factors.
Dietary Therapy
For some people, particularly children, a specific diet called the ketogenic diet may help control seizures. This diet is high in fats and low in carbohydrates. Other dietary approaches include the modified Atkins diet and the low glycemic index diet. These diets should be undertaken with guidance from a healthcare provider.
Vagus Nerve Stimulation
This involves implanting a device that stimulates the vagus nerve in your neck, which can help prevent seizures. The device is programmed to stimulate the nerve at specific times, but you can also activate it manually if you feel a seizure coming on.
Home Remedies
Adequate Sleep
Lack of sleep can trigger seizures in many people with epilepsy. Aim for 7-8 hours of quality sleep each night and maintain a regular sleep schedule by going to bed and waking up at the same time every day.
Stress Management
Stress is a common seizure trigger. Practice stress-reduction techniques such as deep breathing, meditation, yoga, or mindfulness. Regular exercise can also help reduce stress and may have additional benefits for seizure control.
Avoid Alcohol and Recreational Drugs
Alcohol and recreational drugs can interact with anti-seizure medications and may trigger seizures. It's generally recommended to avoid these substances if you have epilepsy.
Stay Hydrated
Dehydration can lower the seizure threshold in some people with epilepsy. Make sure to drink enough water throughout the day, especially in hot weather or during physical activity.
Maintain a Seizure Diary
Keep track of when seizures occur, what you were doing before them, and any potential triggers. This information can help you identify patterns and potentially avoid seizure triggers in the future. It's also valuable information for your healthcare provider.
Preventive Care
- Take anti-seizure medications exactly as prescribed by your doctor.
- Get adequate sleep and maintain a regular sleep schedule.
- Eat regular meals and stay hydrated.
- Avoid known seizure triggers, which can include specific foods, flashing lights, or certain activities.
- Manage stress through relaxation techniques, meditation, or counseling.
- Avoid alcohol and recreational drugs, which can trigger seizures or interact with anti-seizure medications.
- Wear a medical alert bracelet or carry a medical identification card that indicates you have epilepsy.
- Regular exercise is generally beneficial, but certain precautions may be needed, such as swimming with a buddy.
- Have regular check-ups with your healthcare provider to monitor your condition and medication effects.
- Keep a seizure diary to track seizures, triggers, and medication side effects to discuss with your doctor.
Surgical Options
Resective Surgery
A procedure where the area of the brain causing seizures is removed. This is most commonly done when seizures originate from a specific, small area of the brain and that area can be safely removed without affecting important functions. The most common type is temporal lobe resection, where part of the temporal lobe is removed.
Learn More About This ProcedureDeep Brain Stimulation (DBS)
A procedure where electrodes are implanted in specific areas of the brain and connected to a device similar to a pacemaker. The device sends electrical impulses to the brain to help prevent seizures. This procedure is typically considered when medications and other treatments haven't controlled seizures effectively.
Learn More About This ProcedureVagus Nerve Stimulation (VNS)
A device is implanted under the skin in the chest with a wire that connects to the vagus nerve in the neck. The device sends regular, mild electrical stimulations to the brain through the vagus nerve to help prevent seizures. This is typically used when other treatments haven't been effective and resective surgery isn't an option.
Learn More About This ProcedureSchedule a Consultation
If you're experiencing symptoms of epilepsy, our expert team is here to help you find the right treatment approach for your specific needs.