Epilepsy

Overview

Epilepsy

Epilepsy, sometimes called a seizure disorder, refers to a disorder which causes recurring seizures. 

Characteristics

People with epilepsy experience recurrent seizures which are not attributed to any other cause such as low blood sugar, high fever, or concussion. A single seizure, or a few episodes of seizures with a high fever that do not occur when the fever abates is not epilepsy so not everyone who has seizures has epilepsy.

What is a seizure?

A seizure is a temporary loss of consciousness caused by nerve cells in the brain which signal abnormally or excessively. The nerve cells in the brain — known as neurons — create electrical impulses which cause muscles to move, thoughts, actions, and control the body. So, during a seizure the excessive activity of the neurons can cause abnormal movements, loss of consciousness, or behavioral changes depending on what part of the brain is experiencing the seizure.

The major types of seizures include grand mal seizures, focal (frontal, parietal, or occipital lobe) seizures, temporal lobe (psychomotor) seizures, and minor (petit mal, myoclonic, akinetic) seizures. About 3% of all children may have benign febrile convulsions.

Incidence

About 1% of the general population has epilepsy, three-fourths of whom develop it before the age of twenty-one. Of diagnosed epileptics,

  • 80% will have a good control of seizures through medication;
  • 10% will obtain fair medical control;
  • 10% will be poorly controlled or intractable.

It is estimated that about one-half of the epileptic population in California is undiagnosed or unrecognized.

Outlook

It is important to do a complete neurological examination to determine the cause of seizures and if epilepsy is the correct diagnosis. The neurological exam will generally include an electroencephalogram (EEG) and sometimes a brain scan [computed tomography (CT) or magnetic resonance imaging (MRI)]. These diagnostic tools help the doctor determine the type and degree of brain wave abnormality and help to rule out other causes for the seizures.

Treatment options for epilepsy can include:

  • Antiepileptic Medications: There are many drugs available now, and multiple factors are involved in selecting the right one for each patient. If a person with epilepsy is placed on medication to control the seizure activity, blood levels are requested periodically to determine the level of the medication in the body.
  • Surgery: some kinds of epilepsy occur in a very specific part of the brain — the “seizure focus.” Sometimes having surgery to remove the seizure focus can be effective in making seizures easier to control or even stopping them.
  • Other options: when medications aren’t enough and surgery isn’t an option, some people with epilepsy benefit from other treatments including the ketogenic diet (a high fat, low carbohydrate diet with restricted calories) and vagus nerve stimulation.

The vast majority of people with epilepsy live a full life.

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