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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
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Generalized seizures occur all over the brain and can affect the entire
body. Symptoms of general seizures include:
convulsions
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
stroke
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.
Diagnosis
The CDC 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.
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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 for you.
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 year.
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.
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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 epilepsy
include:
family practitioners
pediatricians
internists
neurologists
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.
Complications
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 epilepsy.
Prevention
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.
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