Epilepsy

Epilepsy is a disorder that causes groups of nerve cells in the brain to send too many abnormal signals of electrical energy. The result is a seizure, which may cause unusual nerve activity that produces strange sensations, emotions, and behavior or convulsions, muscle spasms, and loss of consciousness. Epilepsy is sometimes called a seizure disorder, because seizures are a symptom of epilepsy. However, not everyone who has a seizure has epilepsy.

Single seizures may be caused by a high fever, severe head injury, a lack of oxygen, or a number of other causes. About one half of all seizures have no known cause. There may be many different causes of epilepsy, but much of the time, the cause is not known. Some people may be born with an abnormal gene that can cause epilepsy. Epilepsy can start from many other disorders, such as brain tumors, alcoholism, Alzheimer's disease, meningitis, AIDS, and other infectious diseases. Other causes can be a head injury, or poisoning from a drug, lead, or carbon monoxide. Epilepsy is not contagious, is not caused by mental retardation, nor does it cause mental retardation.

Seizures may be categorized as either partial or generalized. Partial seizures occur in just one area of the brain. During a simple partial seizure, the person will stay awake, but have unusual feelings or sensations, such as joy, anger, sadness, or nausea. The person may also hear, smell, see, or feel things that are not real. A complex partial seizure may cause a person to lose consciousness or be in a dream-like state. The person may do unusual things like blinking, mouth movements, or walking in a circle. Sometimes they may throw things. These seizures last only a few seconds.

Generalized seizures involve many areas of the brain. This kind of seizure may cause loss of consciousness, falls, or muscle spasms. Absence seizures, or petit mal seizures, are generalized seizures. During these seizures, a person may appear to be staring off into space and may have jerking or twitching muscles. They may not know that they had a seizure. Tonic-clonic or grand mal seizures are the more severe form of generalized seizures. During these seizures the person will lose consciousness and the body will be stiff with repeated jerks of the arms and/or legs.

Some people may have both partial and generalized seizures. Seizures may also start as a partial seizure and then spread to the entire brain to become a generalized seizure.

If a person has a first-time seizure, it is very important to see a healthcare provider. The provider may feel that there was a cause for a one-time seizure, such as a high fever. If this is the case, the person may not be treated. Whether there is an obvious cause or not, the provider will ask details about the seizure and what the person was doing right before the seizure occurred. The provider may order an electroencephalograph, or EEG, which records brain waves. An EEG can detect abnormal electrical activity in the brain. Other tests that may be done are brain scans, blood tests, and developmental, neurological or behavioral tests.

Treatment of epilepsy usually begins with taking prescription medication to stop seizures or make them occur less often. Certain types of seizures may be treated with brain surgery to control or stop them. Sometimes a special diet called a ketogenic diet is used that seems to control some seizures. The diet is mostly used in children, but adults may also be given the diet to follow. The diet is very strict, very high in fats, and low in carbohydrates. It makes the body burn fat instead of glucose for energy. The ketogenic diet is complicated and requires the person to be monitored closely because of possible side effects. Scientists are not sure how the diet works to control seizures.

Another option may be a vagus nerve stimulator. This device is surgically inserted under the skin in the chest. Wires from the device are attached to the vagus nerve in the neck. The stimulator sends bursts of electricity to the brain through the vagus nerve to prevent or interrupt the abnormal electrical activity. This option may help reduce the number of seizures. A person still needs to take medication, but may be able to take lower doses.

When diagnosed with epilepsy, it is very important to follow the healthcare provider's exact instructions for medication and keep all follow-up appointments with the provider. Keeping a regular sleep schedule and minimizing stress can help control seizures. Even lack of sleep can trigger seizures in some people.

Although there is no cure for epilepsy, it can be controlled. Occasionally, for some people, epilepsy may go away. Most people live full active lives, even though there may be some restrictions on what they are able to do.

One concern is the amount of time a seizure lasts. Most seizures will last for a few seconds to a minute or two. If a seizure lasts for more than 5 minutes, the person having the seizure should be taken to the emergency department immediately. Sometimes the seizure may not be a convulsive type, but the person may have a long period of being confused or agitated. Persons with this type of seizure need immediate emergency care.

Last Reviewed 2005

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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