Epilepsy is a neurological disorder in which patients experience recurrent seizures. At least two seizures must occur before epilepsy is diagnosed.
An epileptic seizure occurs when the nerve cells in the brain suddenly increase their activity, causing an electrical storm that can overwhelm the brain. This can result in various symptoms ranging from slight changes in taste or smell to loss of consciousness and involuntary muscle contractions that affect the whole body. The symptoms experienced depend on the area of the brain affected.
Anything that disrupts the normal function of the brain can cause seizures and epilepsy. Although roughly half of all seizures have no known cause, there are certain factors that can trigger seizures, such as brain trauma, genetic abnormalities, infections and tumors.
Depending on the severity and frequency of seizures, epilepsy can cause significant disruption to a person’s life. People with epilepsy may be unable to keep a job or live independently. They may live in fear of their next seizure. Even people who can control their seizures may experience frustration or the ill effects of others’ perception of epilepsy.
People may have seizures that are unrelated to epilepsy. For example, young children with high fevers may develop febrile seizures. Pregnant women may develop a serious condition called eclampsia that involves seizures. Some people appear to have seizures, but there is no evidence of abnormal electrical activity in the brain. These are called pseudoseizures and they may be psychological in nature, resulting from stress or other medical conditions. Some people with epilepsy may experience pseudoseizures in addition to actual seizures.
Signs and symptoms of epilepsy
The signs and symptoms of epilepsy vary depending on the part of the brain affected and the type of seizure (whether partial or generalized). Some seizures may barely be noticeable to the patient or witnesses.
Signs and symptoms of partial and generalized seizures may include:
People who witness an epileptic seizure should not attempt to move or disturb the person while the seizure is taking place. Instead, they should move any objects that may cause harm to the person. Nothing should be placed in the person's mouth (including fingers). Contrary to popular belief, it is physically impossible for a person to swallow their own tongue during a seizure. If this is the first time a person has had a seizure or if the seizure lasts five minutes or more, emergency services should be called.
Diagnosis methods for epilepsy
Diagnosis of epilepsy usually begins with a medical history and physical examination. Because there are many different types of seizures, some of which are not related to abnormal brain activity, it is important that a physician identify the type of seizure a patient has had. The physician may ask questions that relate to:
If patients do not remember the nature of their seizures, a physician may ask questions of the patient’s caregiver, parents or others who have witnessed the seizures. The physician may also ask about any other conditions or symptoms the patient has, any medications the patient may be taking, and whether the patient uses alcohol or drugs.
In addition to the medical history and physical examination, a physician may conduct tests to assess which areas of the brain may be involved in the seizures. These tests may include:
Treatment options for epilepsy
There is no cure for epilepsy. However, 80 percent of people with epilepsy are able to effectively control their seizures through various treatment methods, according to the National Institute of Neurological Disorders and Stroke (NINDS). Treatment should begin as soon as possible after diagnosis. Studies have shown that patients are more likely to be able to control their seizures effectively if treatment is started early.
The most common treatment method for epilepsy is the use of anticonvulsant (anticonvulsants). These medications attempt to control the area of the brain that triggers the seizures. For this reason, it is important that a patient’s seizures be accurately classified before treatment is started. Patients are usually prescribed a low initial dose of one type of anticonvulsant. Their progress will then be monitored by a physician to assess if the anticonvulsant is effective or if the dosage level needs to be adjusted. Patients should understand what side effects are possible so they can report them to their physician. In some cases, a patient may require two types of anticonvulsants to control the seizures.
For some people with epilepsy, medications fail to control their seizures. In these cases, a physician may recommend additional treatment methods that may be used with medications. These treatment methods include: