Epilepsy is a problem with the brain’s electrical system. Electrical impulses cause brief changes in movement, behavior, feeling, or awareness. These events, known as seizures, may last from a few seconds to a few minutes. People who have had two or more seizures without obvious triggers separated by at least 24 hours are considered to have epilepsy.
Epilepsy is widely known for causing convulsions -- sudden, uncontrolled movements. But seizures can trigger a wide range of other symptoms, from staring to falling to fumbling with clothes. Doctors divide seizures into different types depending on how the brain is affected. Each has its own set of symptoms.
Absence seizures are often described as staring spells. The person stops what he is doing and stares vacantly for a few seconds, then continues as if nothing happened. This type of seizure is more common in children and usually starts between the ages of 4 and 12. Some children have as many as 100 absence seizures in one day.
Generalized Tonic-Clonic Seizures
Generalized tonic clonic seizures (formerly known as grand mal seizures) are the most easily recognized. They usually begin with a stiffening of the arms and legs, and are followed by jerking motions. These convulsions can last up to 3 minutes. After having one, a person may be tired and confused. This type of seizure involves both sides of the brain.
In partial seizures, just one side of the brain is affected. A person having a simple partial seizure may have jerking motions or hallucinations, and still be aware of what is happening. When having a complex partial seizure, a person may wander, mumble, smack their lips, or fumble with their clothes. He or she may appear to be conscious to those around them, but is actually unaware of what they are doing.
Causes of Epilepsy
Anything that disrupts the brain’s natural circuitry can cause epilepsy, such as:
Severe head injury
Brain infection or disease
A specific cause is never found for nearly two-thirds of people with epilepsy.
Epilepsy in Children
Children with epilepsy may outgrow it in a few years. Before then, many kids are able to stop seizures by taking regular medication. If drugs alone don't keep it under control, other treatments may help. A well-informed school staff can help a child with epilepsy safely take part in most activities.
A doctor will review the description of your seizures and your medical history and examine you. An EEG (electroencephalogram) can confirm a diagnosis and give more information about your seizures. It’s a painless procedure that records the brain’s electrical activity as wavy lines. The pattern changes during a seizure and may show which part of the brain is affected. That can help guide treatment.
Diagnosis: Brain Scan
Detailed images of the brain from CT or MRI scans can help doctors rule out tumors or blood clots as a cause of seizures. A CT scan is a powerful type of X-ray, and an MRI uses magnets and radio waves to make pictures. This information will help your doctor come up with the best treatment plan for you.
The best way to avoid complications is to find a treatment that helps you and stick with it. Most people with epilepsy live long lives and rarely are injured during their seizures. A person who tends to fall during seizures may need a special helmet to protect his head. Some types of seizures may increase the risk of death, but this is rare.
Epilepsy Safety Precautions
Because seizures often strike without warning, certain activities can be dangerous. Losing consciousness while swimming or even taking a bath could be life-threatening. The same goes for many extreme sports, such as mountain climbing. Most states require you to be seizure-free for a certain amount of time before driving a car.
Anti-seizure drugs are the most common treatment for epilepsy. If a medication isn't successful, your doctor may adjust the dosage or switch to a different drug. About two-thirds of people with epilepsy become seizure-free by taking their medication as prescribed.
Treatment: Ketogenic Diet
If medications fail or cause side effects, a doctor may recommend this special diet. It's strict, and you'll needs to be watched closely by a medical team. The diet is high in fat and low in carbs, a combination that makes the body burn fat instead of sugar. This creates changes in the brain that help reduce seizures. More than half of children who follow this diet have at least 50% less seizures. Some even stop having seizures.
VNS stands for vagus nerve stimulation, a treatment that is sometimes called a “pacemaker for the brain.” A small device is placed under the skin of the chest. It sends electrical pulses to the brain, through a large nerve in the neck called the vagus nerve. VNS may be an option for people who don't do well with medication.
If you have partial seizures, surgery may stop them. If the medical team can determine that your seizures always begin in a single area of the brain, removing the area may stop them or make them easier to manage. Surgery may also treat conditions that cause the seizures, such as a brain tumor.
First Aid for Seizures
If you see someone having a seizure, take the following steps:
Time how long it lasts.
Clear the area of anything hard or sharp.
Loosen anything at the neck that may affect breathing.
Turn the person onto his or her side.
Put something soft beneath the head.
Don't place anything inside the mouth.
Call 911 if a seizure lasts more than 5 minutes, happens again, or the person is pregnant, injured, or diabetic.
Treatment for Status Seizures
Long-lasting or recurring seizures may be a condition called status epilepticus. It can have serious complications and needs emergency treatment. To bring the seizures to an end quickly, hospitals often give drugs by IV, along with oxygen.
Epilepsy and Pregnancy
In most cases, it is safe for women with epilepsy to become pregnant. More than 90% of babies born to women with epilepsy are healthy. But if you're planning to get pregnant, talk to your doctor first. Anti-seizure drugs can cause risks for infants, and some have more risks than others. You may need to change or adjust your medication.
Service dogs can be trained to behave a certain way during a seizure. For example, the dog can lie next to the person to help prevent injury. In the case of a child, a dog may be trained to alert the parents during a seizure.
Researchers are still looking for new treatments with two goals. The first is to increase the number of people who can fully control their seizures. The second is to reduce the side effects of treatment. Some researchers are also studying implantable devices that could alert patients when a seizure is about to happen.
Living With Epilepsy
People with epilepsy can enjoy full, active lives. Most are able to live seizure-free by taking medication on schedule. For the remainder, there are many resources for coping with uncontrolled seizures. A specialist can help create strategies for reducing the impact your epilepsy has on your life. The American Academy of Neurology and the Epilepsy Foundation provide listings of neurologists who specialize in epilepsy.
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.