What is Epilepsy?

Epilepsy is a disorder in which a person has repeated seizures over time.

A seizure is a release of abnormal electrical activity in the brain. Seizures can cause a change in attention, behavior, or the ability to remain awake and alert. Seizures often involve uncontrollable shaking (convulsions).

Most people with epilepsy lead normal lives. However, people with epilepsy are at an increased risk of falls, accidents, and injuries. Therefore, it is important to begin treatment right away.

Causes of Epilepsy

Epilepsy has many possible causes. Anything that disturbs the normal pattern of brain cell activity can lead to seizures. This may include:

• Head injury
• Birth trauma
• Bleeding into or around the brain
• Stroke
• Certain drugs
• Prolonged low oxygen
• Abnormal brain development
• Certain illnesses, such as meningitis, encephalitis (brain infection), malaria, and other infections
• An imbalance of nerve signaling chemicals (neurotransmitters)

Epilepsy Symptoms

The symptoms of a seizure can vary greatly from one person to another. Right before a seizure, you may have a warning (aura) that a seizure is about to occur. An aura may include the following symptoms:

• Fear or anxiety
• Nausea
• Feeling like the room is spinning (vertigo)
• Vision changes, such as seeing flashing lights or spots

Common epilepsy symptoms during a seizure include:

• Abnormal sensations, such as an abnormal smell or a bitter taste in the mouth
• Sudden, general body stiffness
• Convulsions that involve rhythmic jerking of the face, arm, or leg on one or big sides
• Sudden change in consciousness
• Appearing to be awake but not responding
• Appearing to be asleep but cannot be awakened
• Grimacing, chewing, lip smacking, drooling, tongue biting, or loss of bowel or bladder control

Epilepsy Diagnosis

Your health care provider will ask about your symptoms and take a medical history. Any descriptions from witnesses to your seizures will be very helpful in the diagnosis. A physic al exam, including a detailed neurological exam, is necessary.

Various test may be done, such as:

• An electroencephalogram (EGG). This is a painless test of your brain waves. In this test, a diagram is created of your brain waves.
• An MRI of the brain
• A CT scan of the brain
• A spinal tap (lumber puncture, LP.)
• Blood tests to check for signs of infection or abnormal blood chemistry

Treatment

There is no cure for epilepsy, but it is generally treatable. Once epilepsy is diagnosed, it is important to begin treatment as soon as possible.

For most people, seizures can be controlled with medications. The following may also be used:

• A pacemaker for the brain (vagus nerve stimulator) can be used for people with seizures that are not well controlled by medicine
• Surgery on the brain

For some people, epilepsy eventually goes away.

Home Care Instructions

• Follow your health care provider’s recommendations on driving and safety in normal activities
• Get enough rest. Lack of sleep can cause triggers
• Only take over the counter or prescription medication as directed by your health care provider. Take any prescribed medicine exactly as directed
• Avoid any known triggers of your seizures
• Keep a seizure diary. Record what you recall about any seizure, especially any possible trigger.
• Make sure the people you live and work with know that you are prone to seizures. They should receive instructions on how to help you.
• In general, a witness to a seizure should:
  • Cushion your head and body
  • Turn you on your side
  • Avoid unnecessarily restraining you
  • Not place anything inside your mouth
  • Call for emergency medical help if there is any question about what has occurred

Follow up with your health care provider as directed. You may need regular blood tests to monitor the levels of your medicine.