What is epilepsy?
Epilepsy is a long-term (chronic) disease that causes repeated seizures due to abnormal electrical signals produced by damaged brain cells. A burst of uncontrolled electrical activity within brain cells causes a seizure. Seizures can include changes to your awareness, muscle control (your muscles may twitch or jerk), sensations, emotions and behavior.
Epilepsy is also called a seizure disorder.
What are the signs and symptoms of epileptic seizures?
The main symptom of epilepsy is recurring seizures. Your symptoms, however, vary depending on the type of seizure you have.
Seizure signs and symptoms include:
- Temporary loss of awareness or consciousness.
- Uncontrolled muscle movements, muscle jerking, loss of muscle tone.
- Blank stare or “staring into space” look.
- Temporary confusion, slowed thinking, problems with talking and understanding.
- Changes in hearing, vision, taste, smell, feelings of numbness or tingling.
- Problems talking or understanding.
- Upset stomach, waves of heat or cold, goosebumps.
- Lip-smacking, chewing motion, rubbing hands, finger motions.
- Psychic symptoms, including fear, dread, anxiety or déjà vu.
- Faster heart rate and/or breathing.
Most people with epilepsy tend to have the same type of seizure, so have similar symptoms with each seizure.
How is epilepsy treated?
Treatments to control epilepsy include anti-seizure medications, special diets (usually in addition to anti-seizure medications) and surgery.
Anti-seizure medications
Anti-seizure medications can control seizures in about 60% to 70% of people with epilepsy. Anti-seizure medication treatment is individualized. The U.S. Food and Drug Administration (FDA) has approved more than 20 anti-seizure medications for treating epilepsy. Your healthcare provider may try one or more medications, doses of medications or a combination of medications to find what works best to control your seizures.
Choice of an anti-seizure medication depends on:
- Seizure type.
- Your prior response to anti-seizure medications.
- Other medical conditions you have.
- The potential for interaction with other medications you take.
- Side effects of the anti-seizure drug (if any).
- Your age
- General health.
- Cost.
Because some anti-seizure medications are linked to birth defects, let your healthcare provider know if you’re pregnant or planning to become pregnant.
If anti-seizure medications don’t control your seizures, your healthcare provider will discuss other treatment options, including special diets, medical devices or surgery.
Diet therapy
The ketogenic diet and the modified Atkins diet — diets high in fat, moderate in protein and low in carbohydrates — are the two most common diets sometimes recommended for people with epilepsy. Diets are mostly recommended for children where medication was not effective and who aren’t candidates for surgery. Low glycemic index diets may also reduce seizures in some people with epilepsy.
Surgery and devices
Your healthcare provider will consider surgery if anti-seizure medications don’t control your seizures, and if your seizures are severe and debilitating. Epilepsy surgery can be a safe and effective treatment option when more than two anti-seizure medication trials fail to control your seizures. It’s important to be evaluated at an epilepsy center to see if you’re a candidate for epilepsy surgery if anti-seizure medications don’t control your seizures.
Surgery options include surgical resection (removal of abnormal tissue), disconnection (cutting fiber bundles that connect areas of your brain), stereotactic radiosurgery (targeted destruction of abnormal brain tissue) or implantation of neuromodulation devices. These devices send electrical impulses to your brain to reduce seizures over time.
How is epilepsy diagnosed?
Technically, if you experience two or more seizures that weren’t caused by a known medical condition — for example, from alcohol withdrawal or low blood sugar — you’re considered to have epilepsy. Before making a diagnosis, your healthcare provider (or epilepsy specialist) will perform a physical exam, take your medical history and may order blood work (to rule out other causes). They may ask about your symptoms during the seizure and conduct other tests, as well.
Your healthcare provider will ask you or your family member (who’s witnessed your seizure) if you experienced any of the following during a seizure:
- Muscle jerks.
- Muscle stiffness.
- Loss of bowel or bladder control (you peed or pooped during the seizure).
- Change in breathing.
- Skin color turned pale.
- Had a blank stare.
- Lost consciousness.
- Had problems talking or understanding what was said to you.
What tests will be done to diagnose this condition?
Tests include:
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