What is Epilepsy?
What is Epilepsy?
Epilepsy is the fourth most common neurological disorder and affects people of all ages. Epilepsy is a chronic disorder, the hallmark of which is recurrent, unprovoked seizures. A person is diagnosed with epilepsy if they have two unprovoked seizures (or one unprovoked seizure with the likelihood of more) that were not caused by some known and reversible medical condition like alcohol withdrawal, fever or extremely low blood sugar.
How is Epilepsy Diagnosed?
Knowing if a person is having a seizure and diagnosing the type of seizure or epilepsy syndrome can be difficult. There are many other disorders that can cause changes in behavior and can be confused with epilepsy.
Since the treatment of seizures depends on an accurate diagnosis, making sure that a person has epilepsy, and knowing what kind is a critical first step. What happens during a seizure is one of the most important pieces of information. And, since seizures rarely happen in a doctor’s office, the information given to the doctor and other healthcare professionals by the patient or other witnesses is extremely important.
A person is diagnosed with epilepsy if they have two unprovoked seizures (or one unprovoked seizure with the likelihood of more) that were not caused by some known and reversible medical condition like alcohol withdrawal, fever or extremely low blood sugar. EEG (electroencephalogram) testing is a helpful diagnostic tool and it may be one of the first tests ordered by your doctor.
Most Common Characteristics?
Seizures can take on many different forms, and seizures affect different people in different ways. Anything that the brain does normally can also occur during a seizure when the brain is activated by seizure discharges. Some people call this activity “electrical storms” in the brain. Many different symptoms happen during a seizure.
For generalized onset seizures:
- Motor symptoms may include sustained rhythmical jerking movements (clonic), muscles becoming weak or limp (atonic), muscles becoming tense or rigid (tonic), brief muscle twitching (myoclonus), or epileptic spasms (body flexes and extends repeatedly).
- Non-motor symptoms are usually called absence seizures. These can be typical or atypical absence seizures (staring spells). Absence seizures can also have brief twitches (myoclonus) that can affect a specific part of the body or just the eyelids.
For focal onset seizures:
- Motor symptoms may also include jerking (clonic), muscles becoming limp or weak (atonic), tense or rigid muscles (tonic), brief muscle twitching (myoclonus), or epileptic spasms. There may also be automatisms or repeated automatic movements, like clapping or rubbing of hands, lip smacking or chewing, or running.
- Non-motor symptoms: Examples of symptoms that don’t affect movement could be changes in sensation, emotions, thinking or cognition, autonomic functions (such as gastrointestinal sensations, waves of heat or cold, goosebumps, heart racing, etc.), or lack of movement (called behavior arrest).
Treating or Treatments?
Anti-seizure medicines are the mainstay of epilepsy treatment. When medications don’t help there are other options including epilepsy surgery, special diets, devices and clinical trials of new medications and surgical treatments.
Who should I consult if I suspect?
If you suspect you may be having seizures you should discuss with your primary care doctor. Your doctor will determine if additional testing is required to rule out other causes. Your doctor will then determine if a referral to a neurologist is required. For patients that have been diagnosed with epilepsy and medication is not helping, they need to be referred to an epilepsy center.
Any helpful learning strategies about Epilepsy?
Patients diagnosed with epilepsy should read more about their condition. Patients should reach out to their local Epilepsy Foundation and if there is no local Epilepsy Foundation, then reach out to National Epilepsy Foundation for additional resources and for support.
The health care provider should: Ask at each visit how many different types of seizures you have and how often you have each type. If you are not seizure free, your healthcare provider should discuss a change in treatment to improve seizure control or why a treatment change is not indicated or needed. Ask at each visit whether you have any medication side effects and then takes steps or actions to improve them.
Review at each visit the cause of your epilepsy or the name of your epilepsy syndrome, unless the cause is unknown. Discuss each year seizure safety that is relevant to your type of seizures, your age, and other circumstances.
Ask about depression, developmental problems, or similar problems at each visit. Consider referring you to an epilepsy center if you have had persistent seizures in the past two years, despite trying at least two anti-seizure medications.
Discuss the effects of seizure medication on pregnancy each year if you are a woman who could get pregnant.
What are the first steps to take?
Always reach out to your primary care physician if you suspect or family member suspects you may be having seizures.
Seizure First Aid Video:
Seizure First Aid downloadable pdf
With a network of nearly 50 partners throughout the U.S. the Epilepsy Foundation connects people to treatment, support and resources; leads advocacy efforts; funds innovative research and the training of specialists, and educates the public about epilepsy and seizure first aid.
Answers provided by:
Angel W. Hernandez, MD, FAAP, FAES
Dr. Angel Hernandez is a member of the Epilepsy Foundation’s Professional Advisory Board and the chief of the Division of Neurosciences at the Helen DeVos Children’s Hospital in Grand Rapids, Michigan.