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
Generalized seizures occur all over the brain and can affect the entire body. Symptoms of general seizures include:
- 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
- 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.
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.
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.
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
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.
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.
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.