Epilepsy

• What is epilepsy?

• What are the different types of seizures caused by epilepsy?

• What causes epilepsy?

• Who is most likely to have epilepsy?

• What are the signs and symptoms of epilepsy?

• How is epilepsy diagnosed?

• What are the treatment choices for epilepsy?

• Does epilepsy have to be treated?

• What else can I do to control my seizures?

• What questions might I ask my healthcare provider about treating epilepsy?

What is epilepsy?

Epilepsy (EP-uh-LEP-see) is a brain disorder. It occurs when the electrical signals in the brain are disrupted. This change in the brain leads to a seizure (SEE-zhur). Seizures can cause brief changes in a person’ s:

• Body movements
• Awareness
• Emotions
• Senses, such as taste, smell, vision, or hearing

Some people may only have a single seizure during their lives. One seizure does not mean that a person has epilepsy. People with epilepsy have repeated seizures.

 

What are the different types of seizures caused by epilepsy?

There are 2 types of seizures. Each has its own set of symptoms.

Partial seizures are the most common type of seizure in adults with epilepsy. They occur when changes in electrical signals begin in one area of the brain. Three kinds of partial seizures are:

• Simple partial seizures. This type of seizure affects a small area of the brain. It lasts no more than a few seconds in most cases. Simple partial seizures do not affect consciousness. Sometimes the person just notices unusual feelings.
• Complex partial seizures. These seizures occur through a larger area of the brain. A loss of consciousness occurs. Sometimes the person will stop speaking, act strangely, or have repetitive movements.
• Secondarily generalized seizures. Simple and complex partial seizures that start in one part of the brain can spread through the entire brain. These are known as secondarily generalized seizures. Once the entire brain is affected, there can be a loss of consciousness and shaking of all of the limbs.

Generalized seizures occur when the changes in electrical signals spread through the entire brain at once. The most common generalized seizures are:

• Generalized tonic-clonic seizures. This type is also known as grand mal seizures. It causes rapid movements of all limbs for 1 to 2 minutes or more. It also causes a person to become unconscious. Recovery can sometimes take hours.
• Absence seizures. This type, also known as petit mal seizures, occurs mostly in children. It causes staring and changes in the level of consciousness.

 

What causes epilepsy?

In 70% of people with epilepsy, the cause is unknown. However, in some cases of epilepsy, seizures either run in families or are caused by short-term or lasting scarring or damage to the brain from:

• Head injury
• Serious brain infections, such as meningitis
• Brain tumors
• Brain surgery
• Brain abscess
• Stroke
• Alzheimer’s disease or other diseases that change the brain’s structure
• Hardening of the arteries or any condition that keeps blood or oxygen from getting to the brain

For a person with epilepsy, certain things can “trigger” a seizure, including:

• Stress
• Lack of sleep
• Infection
• Starvation or dehydration
• Alcohol
• Flashing lights or strobe lights
• Certain medications
• Withdrawing from an addictive drug (including alcohol)
• Fevers (in children)

 

Who is most likely to have epilepsy?

Approximately 1% of the population, about 300,000 Canadians have epilepsy. Each year an average of 14,000 people learn that they have epilepsy and about 60% of new patients are young children and senior citizens. It is not usually possible to predict who is most likely to have epilepsy.

 

What are the signs and symptoms of epilepsy?

Each type of epilepsy has a set of different symptoms. In some types, the person has a strange sensation before the seizure occurs. This warning sign is known as an aura (OR-uh). Auras vary from person to person. One example of an aura is smelling a strange odor.

Some symptoms of a generalized tonic-clonic (grand mal) seizure include:

• Blank staring
• Severe jerking of arms and legs
• Falls
• Loss of consciousness
• Loss of bowel or bladder control

Some symptoms of an absence (petit mal) seizure include:

• Staring
• Brief body jerks, mainly involving arms
• Brief loss of attention and activity (zoned out)

Any one of these can be a symptom of a simple partial seizure:

• Jerking of one part of the body, such as the shaking of a hand or foot
• Feelings of fear or panic for no reason
• Blinking eyes
• Face twitching
• A change in the way things taste or smell, or look

Some symptoms of a complex partial seizure include:

• Staring and a change in the way things taste or smell, or look
• Repeated movements, such as rubbing hands or smacking lips, or picking at clothing
• Mumbling
• Memory loss

Some symptoms of a secondarily generalized seizure include:

• Severe jerking of limbs
• Falls
• Loss of consciousness
• Stiffening of the body

 

How is epilepsy diagnosed?

All seizures—even seizures that happen just once or for the first time—need to be reported to a health care provider. Seizures have many causes. A health care provider will need to perform several tests before a diagnosis can be made.

The health care provider will ask about past seizures and when they happened. He or she may also ask about past medical conditions or whether anyone else in the family has ever had seizures. The health care provider will want to know how any seizures were treated in the past. Once the medical history is complete, he or she may request other tests. These can include:

• Physical and neurologic (new-row-LAH-jick) exams. These exams can be used to test reflexes, muscle tone and strength, coordination, and balance. They may also test thinking, judgment, and memory.
• Electroencephalogram (ih-LEK-trow-en-SEF-uh-luh-gram), or EEG. This test uses a special machine to look at the electrical activity of the brain. It can show where seizures start in the brain.
• CT (computerized tomography) or MRI (magnetic resonance imaging) scans. Brain scans are used to see if scarring, growths, or other abnormalities are causing seizures.
• Blood tests. These tests help identify other imbalances in the brain that might be causing the seizures.

 

What are the treatment choices for epilepsy?

The goal of epilepsy treatment is to stop seizures. In select cases where medical treatment does not work, surgical treatment may possibly help, although a cure for epilepsy is not available.

The most common treatment is a prescription anti-epileptic drug (also called an anti-convulsant or anti-seizure). Many people with epilepsy can manage their seizures with these medications. Finding the right medication and dosage that works best can take time. Health care providers may need to prescribe a few different medications until they find the right one or the right combination for a patient. It is important to take the medications every day as prescribed, to control your seizures in the best possible way.

For some people whose medications do not control their seizures, other treatment options may include:

• Vagus (VAY-gus) nerve stimulation (VNS). In this process, a small device is placed under the skin in the upper chest area. The device sends electrical impulses to the brain, which may reduce how often seizures occur.
• Surgery. The most common type of surgery treats seizures by removing the small part of the brain where the seizures take place.

 

Does epilepsy have to be treated?

Yes. Treating seizures helps to maintain both a person’s safety and his or her usual way of life. If you do not treat seizures, they can increase in frequency and severity, which can be very harmful. Uncontrolled seizures can cause a loss of body control or awareness. That can make tasks, such as driving a car or crossing a street, more dangerous. In turn, dependency on others may increase. Uncontrolled seizures in a pregnant woman could be harmful to her and her unborn baby. However, medications used to treat epilepsy may also be harmful to the baby. Therefore, pregnant women need to discuss the risks and benefits of treating epilepsy with their healthcare providers.

 

What else can I do to control my seizures?

Anti-epileptic medications can help control seizures when taken correctly. It is vital to:

• Take the medication each day at the same time as directed by the health care provider.
• Don’t skip a dose, even if you have not had a seizure in a while. Take medication regularly to help prevent seizures.
• Talk with the healthcare provider if the medication doesn’t seem to be working or is causing side effects. A patient should never adjust the dose or stop taking a medication on his or her own.
• Follow through with any checkups with the health care provider. Get any blood tests that are ordered.
• Make a note and report any seizures to the health care provider.

In addition to taking anti-seizure medication, make lifestyle choices that reduce triggers for seizures.

• Manage stress effectively.
• Get enough sleep.
• Eat a balanced diet.
• Drink plenty of fluids throughout the day.
• Do not drink alcohol or use recreational drugs.
• When new medications are added, always ask the health care provider or pharmacist about drug interactions.

 

What questions might I ask my health care provider about treating epilepsy?

Preparing a list of questions before you visit with your healthcare provider can help you make the most of your time together. You may want to include the following questions on your list:

• What are my treatment choices?
• What are the benefits of each choice?
• Which treatment is best for me? Why?
• What are the possible side effects of each treatment?

If your healthcare provider has prescribed medication, you may want to ask:

• Why was this medication chosen for me?
• When can I expect this medication to begin working?
• What are the possible side effects of this medication?
• What should I do if I miss a dose?
• Can I take this medication with food?
• Can I break, chew, or crush this medication?
• Are there other medications I should avoid while taking this medication?
• Are there any side effects or problems I should report right away?
• Will I have any seizures while I am on this medication?
• Should I call you if I have any seizures?
• Is it safe for me to drive?

 

Back to top