Epilepsy is a central nervous system disorder (neurological disorder) in which the nerve cell activity in your brain is disturbed, causing a seizure during which you experience abnormal behavior, symptoms and sensations, including loss of consciousness.
Seizure symptoms vary. Some people with epilepsy simply stare blankly for a few seconds during a seizure, while others repeatedly twitch their arms or legs.
About 1 in 100 people in the United States may have an unprovoked seizure once in life. However, a solitary seizure doesn't mean you have epilepsy. At least two unprovoked seizures are generally required for an epilepsy diagnosis.
Even mild seizures may require treatment because they can be dangerous during activities such as driving or swimming. Treatment, which generally includes medications or sometimes surgery, may eliminate or reduce the frequency and intensity of seizures. Some children with epilepsy even outgrow the condition with age.
Because epilepsy is caused by abnormal activity in brain cells, seizures can affect any process your brain coordinates. A seizure can produce symptoms such as:
Symptoms vary depending on the type of seizure. In most cases, a person with epilepsy will tend to have the same type of seizure each time, so the symptoms will be similar from episode to episode.
Doctors generally classify seizures as either focal or generalized, based on how the abnormal brain activity begins.
When to see a doctor
If you experience a seizure for the first time, seek medical advice.
Epilepsy has no identifiable cause in about half of those with the condition. In about half the people with epilepsy, the condition may be traced to various factors.
Certain factors may increase your risk of epilepsy.
Having a seizure at certain times can lead to circumstances that are dangerous to yourself or others.
Other life-threatening complications from epilepsy are uncommon, but do occur.
Preparing for your appointment
You're likely to start by seeing your family doctor or a general practitioner. However, in some cases when you call to set up an appointment, you may be referred immediately to a specialist, such as a doctor trained in brain and nervous system conditions (neurologist) or a neurologist trained in epilepsy (epileptologist).
Because appointments can be brief, and because there's often a lot to talk about, it's a good idea to be well prepared for your appointment. Here's some information to help you get ready for your appointment, and what to expect from your doctor.
What you can do
Preparing a list of questions will help you make the most of your time with your doctor. List your questions from most important to least important in case time runs out. For epilepsy, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.
What to expect from your doctor
What you can do in the meantime
Also, it's important to start keeping a log of your seizures before you visit your doctor.
Tests and diagnosis
To diagnose your condition, your doctor will review your symptoms and medical history. Your doctor may order several tests to diagnose epilepsy and determine the cause of seizures.
Your doctor may also suggest tests to detect brain abnormalities, such as:
If you have epilepsy, it's common to have changes in your normal pattern of brain waves, even when you're not having a seizure. Your doctor may monitor you on video while conducting an EEG while you're awake or asleep, to record any seizures you may experience. Recording the seizures may help the doctor determine what kind of seizures you're having or rule out other conditions.
Your doctor may give you instructions to do something that will cause seizures, such as getting little sleep prior to the test.
A SPECT test uses a small amount of low-dose radioactive material that's injected into a vein to create a detailed, 3-D map of the blood flow activity in your brain during seizures.
Doctors also may conduct a form of a SPECT test called subtraction ictal SPECT coregistered to magnetic resonance imaging (SISCOM), which may provide even more detailed results.
Treatments and drugs
Doctors generally begin by treating epilepsy with medication. If medications don't treat the condition, doctors may propose surgery or another type of treatment.
More than half the children with epilepsy who aren't experiencing epilepsy symptoms can eventually discontinue medications and live a seizure-free life. Many adults also can discontinue medications after two or more years without seizures.
Finding the right medication and dosage can be complex. Your doctor will consider your condition, frequency of seizures, your age and other factors when choosing which medication to prescribe. Your doctor will also review any other medications you may be taking, to ensure the anti-epileptic medications won't interact with them.
Your doctor likely will first prescribe a single medication at a relatively low dosage and may increase the dosage gradually until your seizures are well controlled.
Anti-seizure medications may have some side effects. Mild side effects include:
More severe but rare side effects include:
To achieve the best seizure control possible with medication:
At least half of all people newly diagnosed with epilepsy will become seizure-free with their first medication. If anti-epileptic medications don't provide satisfactory results, your doctor may suggest surgery or other therapies. You'll have regular follow-up appointments with your doctor to evaluate your condition and medications.
If your seizures originate in an area of the brain that controls movement, speech and other functions, you may be awake during part of the surgery. Doctors will monitor you and ask you questions during the procedure.
If your seizures originate in a part of your brain that can't be removed, your doctor may recommend a different type of surgery in which surgeons make several cuts in your brain (multiple subpial transection). These cuts are designed to prevent seizures from spreading to other parts of your brain.
Although many people continue to need some medication to help prevent seizures after successful surgery, you may be able to take fewer drugs and reduce your dosages.
In a small number of cases, surgery for epilepsy can cause complications such as permanently altering your thinking (cognitive) abilities. Talk to your surgeon about his or her experience, success rates and complication rates with the procedure you're considering.
The battery-powered device sends bursts of electrical energy through the vagus nerve and to your brain. It's not clear how this inhibits seizures, but the device can usually reduce seizures by 20 to 40 percent.
Most people still need to take anti-epileptic medication, although some people may be able to lower their medication dose. You may experience side effects from vagus nerve stimulation, such as throat pain, hoarse voice, shortness of breath or coughing.
Potential future treatments
Researchers also study stereotactic radiosurgery as a potential treatment for some types of epilepsy. In this procedure, doctors direct radiation at the specific area of your brain that is causing your seizure.
Functions of the brain
Different areas of the brain are responsible for different vital functions. ...
Vagus nerve stimulation
In vagus nerve stimulation, an implanted pulse generator and lead wire stimulate parts of your brain. ...
Lifestyle and home remedies
Understanding your condition can help you control it.
In addition, make healthy life choices such as managing stress, limiting alcoholic beverages and avoiding cigarettes.
Coping and support
Uncontrolled seizures and their effect on your life may at times feel overwhelming or lead to depression. It's important not to let epilepsy hold you back. You can still live an active, full life. To help cope:
If your seizures are so severe that you can't work outside your home, there are still ways to feel productive and connected to people. You may consider working from home, through working on a computer.
Let people you work and live with know the correct way to handle a seizure in case they are with you when you have one. You may offer them suggestions, such as:
Last Updated: 2013-05-31
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