Epilepsy FAQ’s

EPILEPSY FAQ’s

Find answers to frequently asked questions about epilepsy here.

Epilepsy: What is It?

Epilepsy: Who Gets It?

Facts About Seizures:

Seizure Types

Partial Seizures:

Generalized Seizures

Auras

Medical Emergencies: Status Epilepticus

Epilepsy: Treatment Options

Epilepsy: What is It?

Epilepsy is not a disease, but rather a neurological condition that causes temporary disruptions in the brain’s normal electrical activity. When this disruption occurs, a person experiences a seizure.

Our senses of sight, touch, hearing, and smell; and our ability to move, think and speak, are all governed by messages the brain sends along neural pathways. A seizure is similar to a brief electrical storm that occurs somewhere along this neural “information highway” causing the brain’s communication system to be temporarily disrupted. Similar to the way a computer sends an error message and then needs to reboot, a person experiencing a seizure “shuts down” for a brief period of time until their brain’s normal electrical activity resumes.

The word ‘epilepsy’ is a general term used to describe over forty different types of seizure disorders. They vary in severity; some people experience seizures once or twice a year; others monthly, daily or multiple times per day. Not all seizures are alike; some cause a person to stare blankly, others to have muscle spasms or a convulsion.

Most types of epilepsy can be controlled successfully with medication. Before a doctor can prescribe treatment he must determine the type of seizures occurring, and the probable cause of the seizures. Epilepsy can be traced to many different causes such as a brain injury or a family tendency, but in the majority of cases no cause can be determined.

Epilepsy: Who Gets It?

Epilepsy is a common neurological disorder that anyone can develop, though it is not contagious. It affects over 50 million people worldwide. New cases are most common among children during the first year of life; however children and adults can develop this condition at any age.

Epilepsy can be found in the homes of the wealthy and the poor; the educated and the uneducated; amongst all races, religions and nationalities. Epilepsy is not an indicator of intelligence: people with high, average and low intelligence can have epilepsy. It is not a mental illness; nor does epilepsy cause mental illness.

Before science could explain the causes behind seizures, epilepsy carried a great stigma because of superstition and ignorance. People often hid the fact that they had epilepsy out of shame or fear. Now many famous people with epilepsy worldwide are coming forward to openly talk about their battle in overcoming epilepsy. Publicly admired scientists and politicians, writers and artists, actors and actresses, singers, and even professional athletes who have achieved highly successful careers in spite of epilepsy are bringing the condition out of the shadows and into the light.

Facts About Seizures:

• Most people can effectively control their seizures with medical treatment, and go on to live active, healthy and happy lives.

• Most seizures last only minutes or less, though the person may be confused or tired for a long period afterwards.

• Seizures usually end spontaneously and safely.

• Once a seizure has begun you cannot stop it; simply let it run its course, and then reassure and assist the person afterwards.

• Only in medical emergencies for non-stop seizures do doctors intervene with drugs to try and stop the course of a seizure.

• Seizures are not contagious.

• Epilepsy is not a mental illness, nor does it cause mental illness.

• Having epilepsy is not an indicator of low intelligence. People of high, average and low intelligence can have epilepsy.

• It is highly likely that someone you know personally has epilepsy, even if they haven’t told you about it. Epilepsy affects people like you and me.

Seizure Types

Just as there are many different types of epilepsy, there are also many different types of seizures. Epileptic seizures can be classified into two main groups: partial and generalized seizures. The difference lies in how the seizures begin in the brain. Disruptions in the brain’s electrical activity can temporarily affect a certain part of the brain (partial seizures) or the whole brain (generalized seizures). What a person experiences during a seizure depends on where in the brain the electrical disruption takes place.

Several common seizure types are described below:

Partial Seizures:

• Simple Partial Seizures

During simple partial seizures, the person remains fully conscious but experiences unusual sensations such as tastes, smells, emotions or jerking body movements. These usually pass after several minutes.

• Complex Partial Seizures

During a complex partial seizure a person’s consciousness is altered and they will have no memory of what happened, though to onlookers it may appear they are aware of their actions. The person may seem confused and make repetitive movements such as smacking the lips, chewing, undressing, or wandering about aimlessly. They may express anger or fear, and struggle if restrained. The seizure usually passes after several minutes.

Generalized Seizures

• Absence Seizures

Absence seizures cause a person to briefly lose awareness of their surroundings, stare or blink their eyes, and become unresponsive to others. Absence seizures typically last only seconds and the person is completely alert afterwards. Most people are not aware that they’ve experience an absence seizure; others can tell by the reactions of those around them, or by unexplained gaps in conversations. Undiagnosed absence seizures may be confused with daydreaming or lack of concentration when a child reaches school age. Frequency of seizures greatly varies, from once a day or less to several hundred times per day.

• Tonic-clonic Seizures

This seizure type is what most people commonly associate with epilepsy. The person may cry out, lose consciousness, become stiff and then experience jerking of the limbs. Sometimes urinary or bowel incontinence occurs. Tonic-clonic seizures usually last anywhere from 30 seconds to several minutes. Afterwards the person may feel exhausted, confused, or experience general feelings of anxiety. Some people report temporary slurring of speech after a seizure. Falls during generalized seizures sometimes result in injury or bruises. Though the seizure only lasts minutes, the time it takes to recover may greatly vary. Some people are fine within a short period of time and can carry on normal activities; most need to sleep for a few hours after a seizure and usually feel fine by the next day.

• Tonic Seizures

During a tonic seizure, the body stiffens and the person may fall over, but no twitching or jerking occurs as it does in tonic-clonic seizures. People who experience these seizures usually lose consciousness for about 10 seconds.

• Atonic Seizures (Also called ‘Drop Seizures)

In an atonic seizure, muscle tone is suddenly and completely lost and the person drops to the floor. Sometimes only the head droops or jaw slackens. Consciousness is usually regained after 10 seconds or so, and they can then stand and walk. Recovery time is rapid.

• Myoclonic Seizures

These types of seizures are characterized by jerking movements of the arms, head, shoulders or legs, often soon after waking. Objects may be spilled or dropped.

Auras

Sometimes seizures are proceeded by a certain sensation known as an aura. Auras are actually simple partial seizures. Some people experience a simple partial seizure that does not progress to a generalized seizure. Other people experience aura sensations before their seizure spreads to others parts of the brain and they lose consciousness. People experience auras in different ways: some feel a sense of unexplained confusion or anxiety; others a sense of déjà vu; some feel light-headed and generally unwell; some experience twitching or hand movements. The aura may provide a warning sign that a generalized seizures is coming. This gives the person time to make themselves safe, either by telling someone, or by lying or sitting down to avoid falls.

Medical Emergencies: Status Epilepticus

Seizures usually last only minutes. In status epilepticus, however, seizures do not stop. Though infrequent, this potentially life-threatening condition requires prompt medical treatment. Immediate medical help should be summoned if seizures continue longer than 5 minutes and the patient does not recover consciousness. Hospital treatment involves stabilizing the person with intravenous anti-convulsive drugs and fluids. Status epilepticus can be triggered by sudden withdrawal of anti-seizure medication, as well as other causes.

Epilepsy: Treatment Options

The majority of people with epilepsy can help control their seizures through proper medical treatment. Modern advances in epilepsy treatment have enabled many people with epilepsy to live normal, active lives. Options for treatment include anti-seizure medication, dietary therapy and surgery. It is important to discuss with an epileptoligist (a neurologist specializing in epilepsy) what treatment options are right for you.

Anti-seizure medication

There are many different types of seizure medications, and each type works better for certain types of seizures. It may take several attempts to find the right anti-seizure medication at the right dosage that will provide maximum seizure control with a minimum of side-effects. Work with your doctor to explore your options and report honestly and thoroughly any side-effects you may experience until you find the right medication and dosage for your needs. Anti-seizure medications are effective for 70% of people experiencing seizures.

Dietary therapy:

Ketogenic dietary therapy has been used successfully for many years to help the 30% of people who cannot control their seizures through medication; however, newer and simpler forms of this strict high-fat low-carbohydrate diet have emerged in recent years. The Modified Atkins Diet for Seizures was first developed in 2003 at Johns Hopkins Hospital in the United States, and is being used as a first-line treatment option for certain types of epilepsy. Both the Modified Atkins as well as the traditional ketogenic diet are commonly used to help patients with difficult-to-control seizures, or those who find the side-effects of medication intolerable.

Surgery:

Surgery is considered as an option for some people whose seizures cannot be controlled by medication, depending on where in the brain the seizures originate. Besides surgery, implants such as VNS (vagus nerve stimulation) work in ways similar to heart pacemakers, by sending regular mild pulses of electricity to the brain to help prevent seizures.

Sources:

http://www.epilepsy.com

http://www.ehealthmd.com/library/epilepsy/EPI_kinds.html

http://www.youthhealthtalk.org/Young_people_with_epilepsy/Topic/3500

http://www.epilepsyfoundation.org/about/types/types/statusepilepticus.cfm

http://emedicine.medscape.com/article/908394-overview

http://webspace.webring.com/people/hf/familyhealthrm/seizures.html