Epilepsy is a neurological condition that causes unprovoked, recurrent seizures. A seizure is a sudden rush of abnormal electrical activity in your brain. Doctors diagnose epilepsy when you have two or more seizures with no other identifiable cause.
Anyone can develop epilepsy, but it
The two main types of seizures are:
- generalized seizures
- focal seizures
Generalized seizures affect your whole brain. Focal, or partial seizures, affect only one part of your brain.
A mild seizure may be difficult to recognize. It may only last a few seconds, and you may remain awake while it happens. Stronger seizures can cause spasms and uncontrollable muscle twitches. They can last from a few seconds to several minutes and may cause confusion or loss of consciousness. Afterward, you may have no memory of a seizure happening.
There’s currently no cure for epilepsy, but it can be managed with medications and other strategies.
Seizures are the main symptom of epilepsy. Symptoms differ from person to person and according to the type of seizure.
Focal (partial) seizures
A focal aware seizure (previously called simple partial seizure) does not involve loss of consciousness. Symptoms include:
- alterations to sense of taste, smell, sight, hearing, or touch
- tingling and twitching of limbs
Focal unaware seizures (previously called complex partial seizures) involve loss of awareness or consciousness. Other symptoms include:
- staring blankly
- performing repetitive movements
Generalized seizures involve the whole brain.
- Absence seizures. Absence seizures used to be called “petit mal seizures.” They tend to cause a short loss of awareness, a blank stare, and may cause repetitive movements like lip smacking or blinking.
- Tonic seizures. Tonic seizures cause sudden stiffness in the muscles in your legs, arms, or trunk.
- Atonic seizures. Atonic seizures lead to loss of muscle control. They’re also called “drop seizures” because a sudden loss of muscle strength can make you fall suddenly.
- Clonic seizures. Clonic seizures are characterized by repeated, jerky muscle movements of the face, neck, and arms.
- Myoclonic seizures. Myoclonic seizures cause spontaneous quick twitching of the arms and legs. Sometimes these seizures cluster together.
- Tonic-clonic seizures. Tonic-clonic seizures used to be called “grand mal seizures.” Symptoms include:
- stiffening of the body
- loss of bladder or bowel control
- biting of the tongue
- loss of consciousness
Following a seizure, you may not remember having one, or you might feel slightly ill for a few hours.
It’s important to note that most seizures don’t require emergency medical attention, and you can’t stop a seizure once it’s in progress.
When you’re with somebody having a mild seizure:
- Stay with the person until their seizure ends and they’re awake.
- Once they’re awake, guide them to a safe place and tell them what happen.
- Stay calm and try to keep other people calm.
- Speak calmly.
- Check for a medical bracelet.
- Offer to help the person get home safely.
If the person is having a tonic-clonic seizure, which causes uncontrolled shaking or jerking:
- Ease the person to the ground.
- Turn them gently onto their side to help them breathe.
- Clear any dangerous objects away from them.
- Put something soft under their head.
- If they wear glasses, remove them.
- Loosen any clothing, such as a tie, that may affect breathing.
- Time the seizure and call 911 if it lasts longer than
When someone is having a seizure, it’s critical to never:
- hold the person down or try to stop their movements
- put anything in their mouth
- give them mouth to mouth
- offer the person food or water until they’re fully alert
- traumatic brain injury or other head trauma
- brain scarring after a brain injury (post-traumatic epilepsy)
- serious illness or very high fever
- stroke, which causes
about halfof epilepsy cases in older adults when there’s no identifiable cause, according to the CDC
- lack of oxygen to the brain
- brain tumor or cyst
- dementia, including Alzheimer’s disease
- maternal use of some drugs, prenatal injury, brain malformation, or lack of oxygen at birth
- infectious conditions like HIV and AIDS and meningitis
- genetic or developmental disorders or neurological diseases
Epilepsy can develop at any age, but diagnosis usually occurs in
Researchers first identified genes linked to epilepsy in the late 1990s, according to the Epilepsy Foundation. Since then, they have discovered more than
Not all genes linked to epilepsy are passed down through families. Some gene mutations develop in children even if they’re not present in either parent. These are called “de novo mutations.”
Some types of epilepsy are more common in people with a family history, but most children of people with epilepsy don’t develop epilepsy themselves. According to the Epilepsy Foundation, even if a child has a parent or sibling with epilepsy, the chances that they’ll develop the condition by age 40 is still less than 5 percent.
The chances of developing epilepsy are higher if a close relative has a generalized epilepsy rather than a focal epilepsy. If your parent has epilepsy due to another cause, such as stroke or brain injury, it does not affect your chances of developing seizures.
Certain rare conditions, such as tuberous sclerosis and neurofibromatosis, can cause seizures. These conditions can run in families. Genetics may also make some people more susceptible to seizures from environmental triggers.
If you have epilepsy and are concerned about starting a family, consider arranging a consultation with a genetic counselor.
Some people identify things or situations that trigger their seizures.
A few of the most common known triggers are:
- lack of sleep
- illness or fever
- bright lights, flashing lights, or patterns
- caffeine, alcohol or alcohol withdrawal, medications, or illegal drugs
- skipping meals, overeating, or specific food ingredients
- very low blood sugar
- head injury
Identifying triggers isn’t always easy. A single incident doesn’t always mean something is a trigger. Often, a combination of factors triggers a seizure.
A good way to find your triggers is to keep a seizure journal. After each seizure, note the following:
- day and time
- what activity you were involved in
- what was happening around you
- unusual sights, smells, or sounds
- unusual stressors
- what you were eating or how long it had been since you’d eaten
- your level of fatigue and how well you slept the night before
You can also use your seizure journal to determine if your medications are working. Note how you felt just before and just after your seizure, and any side effects.
Bring the journal with you when you visit the doctor. It may be useful for your doctor if adjusting your medications or exploring other treatments is, or becomes, necessary.
Epileptic seizures disrupt the electrical activity of your brain, which can directly or indirectly affect many parts of your body. Potential complications of epilepsy include:
- learning difficulty (about
20 percentof people with epilepsy have an intellectual disability, according to a 2018 research article)
- injury from falling during a seizure
- injury while operating an automobile or machinery
- brain damage from prolonged and uncontrolled seizures
- choking on food or saliva
- medication side effects
Each year, about
SUDEP is more common in people with epilepsy that is not well managed. Taking all your medication as prescribed and visiting your doctor regularly can help you minimize your risk.
If you suspect you’ve had a seizure, see a doctor as soon as possible. A seizure can be a symptom of a serious medical issue.
Your medical history and symptoms will help your doctor decide which tests will be helpful. They’ll likely give you a neurological examination to test your motor abilities and mental functioning.
To diagnose epilepsy, other conditions that cause seizures should be ruled out. A doctor will probably order a complete blood count (CBC) and chemistry of your blood.
Blood tests may be used to look for:
- signs of infectious diseases
- liver and kidney function
- blood glucose levels
Electroencephalogram (EEG) is the most common test used to diagnose epilepsy. It’s a noninvasive and painless test that involves placing electrodes on your scalp to search for abnormal patterns in your brain’s electrical activity. You may be asked to perform a specific task during the test. In some cases, the test is performed while you sleep.
Imaging tests can reveal tumors and other abnormalities that can cause seizures. These tests might include:
Epilepsy is usually diagnosed if you have seizures, but there’s no apparent or reversible cause.
Treatment for epilepsy may help you have fewer seizures or stop seizures completely.
Your treatment plan will be based on:
- the severity of your symptoms
- your health
- how well you respond to therapy
Some treatment options include:
- Anti-epileptic (anticonvulsant, antiseizure) drugs. Anti-epileptic medications can help reduce the number of seizures you have. In some people, they may eliminate seizures. To be most effective, the medication must be taken exactly as your doctor prescribed.
- Vagus nerve stimulator. This device is surgically placed under the skin on your chest and electrically stimulates the nerve that runs through your neck to prevent seizures.
- Ketogenic diet. According to the Epilepsy Foundation, more than half of children who do not respond to medications benefit from the ketogenic diet, which is a high fat and low carbohydrate diet.
- Brain surgery. The area of the brain that causes seizure activity can be removed or altered if you and your healthcare team determine it’s the right treatment for your condition.
Research into new treatments is ongoing. One treatment that may be more widely available in the future is deep brain stimulation. It involves implanting electrodes into your brain and a generator into your chest. The generator sends electrical impulses to your brain to help decrease seizures.
The FDA approved the use of deep brain stimulation in 2018 in people over 18 years old with focal onset seizures who have not responded to at least three anti-epileptic medications.
Minimally invasive surgeries and radiosurgery are also being investigated.
The first-line treatment for epilepsy is antiseizure medication. These drugs are designed to help reduce the frequency and severity of seizures. They cannot stop a seizure that’s already in progress, and they are not a cure for epilepsy.
These medications are absorbed by your stomach. They then travel through your bloodstream to your brain. They affect neurotransmitters in a way that reduces the electrical activity that leads to seizures.
There are many antiseizure drugs on the market. Your doctor can prescribe a single drug or a combination of drugs, depending on your type of seizure.
Common epilepsy medications include:
- levetiracetam (Keppra)
- lamotrigine (Lamictal)
- topiramate (Topamax)
- valproic acid (Depakote)
- carbamazepine (Tegretol)
- ethosuximide (Zarontin)
These medications are generally available in tablet, liquid, or injectable forms and are taken once or twice a day. Your doctor will initially prescribe the lowest possible dose, which can be adjusted until it starts to work. These medications must be taken consistently and as prescribed.
Some potential side effects may include:
Rare, but serious side effects include depression and inflammation of the liver or other organs.
Epilepsy is different for everybody, but in most cases, people see improvement with antiseizure medication. Some children with epilepsy may stop having seizures and can stop taking medication.
If medication can’t decrease your number of seizures, another option is brain surgery.
The most common surgery is resection. This involves removing the part of your brain where the seizures start. Most often, the temporal lobe is removed in a procedure known as temporal lobectomy. In some cases, this can stop seizure activity.
In some cases, you’ll be kept awake during this surgery so doctors can talk with you and avoid removing part of the brain that controls important functions such as vision, hearing, speech, or movement.
Multiple subpial transection
If the area of the brain is too big or important to remove, surgeons may perform another procedure called a multiple subpial transection, or disconnection. During this procedure, the surgeon makes cuts in your brain to interrupt the nerve pathway. This cut keeps seizures from spreading to other areas of your brain.
After surgery, some people are able to cut down on antiseizure medications or even stop taking them, their doctor’s oversight.
There are risks to any surgery, including a negative reaction to anesthesia, bleeding, and infection. Surgery of the brain can sometimes result in cognitive changes.
It can be a good idea to discuss the pros and cons of the different procedures with your surgeon and other healthcare team members. You may also want to seek a second opinion before making a final decision.
It’s important to see your doctor regularly for checkups. People with well-managed epilepsy should consider meeting with their family doctor or epilepsy specialist at least once per year, according to the National Health Service. People with epilepsy that is not well managed may need to see their doctor more often.
It’s also a good idea to schedule an appointment with your doctor if you experience any new symptoms or if you experience side effects after your medication has been changed.
Epilepsy is a chronic disorder that can affect many parts of your life.
Laws vary from state to state, but if your seizures are not well managed, you may not be allowed to drive.
Because you never know when a seizure will occur, many everyday activities like crossing a busy street can become dangerous. These problems can lead to loss of independence.
In addition to regular doctor visits and following your treatment plan, here are some things you can do to cope:
- Keep a seizure diary to help identify possible triggers so you can avoid them.
- Wear a medical alert bracelet to let people know that you have epilepsy so you get the right medical help if you have a seizure and can’t speak.
- Teach the people closest to you about seizures and what to do in an emergency.
- Seek professional help if you have — or think you have — symptoms of depression or anxiety.
- Join a support group for people with seizure disorders.
- Engage in health-promoting activities like eating a nutrient-rich, balanced diet and getting regular exercise.
Early treatment with medication can help reduce seizure frequency and the chances of serious complications. Epilepsy surgery, meanwhile, is considered curative in most cases.
If medication fails, your doctor may recommend surgery or vagus nerve stimulation.
Two types of brain surgery can cut down on or eliminate seizures. One type, called resection, involves removing the part of the brain where seizures originate.
When the area of the brain responsible for seizures is too vital or large to remove, the surgeon can perform a disconnection. This involves interrupting the nerve pathway by making cuts in the brain. This keeps seizures from spreading to other parts of the brain.
Dozens of other avenues of research into the causes, treatment, and potential cures for epilepsy are ongoing.
Although there’s no cure at this time, the right treatment can result in a dramatic improvement in your condition and your quality of life.
- As many as
500 genesmay relate to epilepsy in some way.
- Strokes cause
about halfof cases of epilepsy in older adults when there is no other identifiable cause.
- About 40 percent of U.S. children with epilepsy between 4 and 15 years old have another neurological disorder. The most common are intellectual disability, speech-language disability, or specific learning disabilities.
- About 1.9 percent of epilepsy-related deaths in the United States are due to prolonged seizures, a condition known as status epilepticus.
- Seizures start in people over 65 years old almost as often as they start in children.
- More than 1 million people in the United States have epilepsy that is not well managed.
80 percentof people with epilepsy live in low income countries and don’t receive proper treatment.
- The cause of epilepsy is unknown about
half of cases worldwide.