Epilepsy

Symptoms

Symptoms of an epileptic seizure vary depending on where the seizure takes place. The brain has many functions relating to mood, memory, movement, emotion, sense, and speech. At least one of these functions will be affected by a seizure.

  • Uncontrolled jerking arm or leg
  • Tingling on one side of body
  • Flashing lights in one half of vision
  • Intense fear
  • Strong memory flashbacks
  • Intense Déjà vu
  • Unpleasant taste
  • Unpleasant smell
  • Hallucinations
  • Lip smacking
  • Blank stare
  • Body stiffness
  • Loss of muscle tone
  • Loss of consciousness
  • Limb jerking
  • Eye deviance

Description

Epilepsy is a brain disorder characterized by seizures. Seizures are sudden bursts of electrical activity interrupting both the mental and physical functions of the brain. These surges of electricity are recurrent and unpredictable. One in 20 persons will experience a seizure in their lifetime. To be diagnosed with epilepsy, you must experience two or more unprovoked seizures.

Epileptic seizures are divided into two broad categories: generalized and partial. In generalized seizures, the whole brain is involved. In partial seizures, the electrical activity starts in one part of the brain, although it can spread to others. Epilepsy is not just classified by seizures. Other factors are taken into account like EEG (brain scan) results, the course of seizure, the type of seizure, response to treatment, and genetic factors. Anyone can be diagnosed with epilepsy, although it is more prevalent in children and older people. An estimated 10.5 million children worldwide have epilepsy.

Causes

With the exception of young children and the elderly, the causes of seizures and epilepsy go unidentified. Only 40% of people know the cause of their epilepsy. If a direct diagnosis for the cause of a person’s epilepsy cannot be made, the cause of epilepsy is described by the seizure type. Seizures types are divided into two groups:

Symptomatic seizures

The cause is linked to a known disease or brain event such as head injury, brain hemorrhage, or infection. Infection usually takes place in the brain itself, as in the case of meningitis, although immunodeficiency diseases, such as HIV, can also cause symptomatic seizures.

Cryptogenic seizures

The cause for the seizure cannot be found. Idiopathic seizures, also known as primary seizures, may be diagnosed when the case of the seizure has a suspected genetic link. Individuals whose parents or siblings have epilepsy have an increased chance of developing the disorder.

Treatment

Treatment of epilepsy aims to control seizures quickly, avoid adverse side effects, and improve a person’s quality of life. There are four common treatment options for epilepsy.

Medication

Most people with epilepsy will take oral anti-epileptic drugs to control their seizures. The drugs suppress symptoms of epilepsy, rather than cure the cause. Doses of drugs are introduced cautiously and may be stepped up gradually, depending on a person’s response. Anti-epileptic drugs interact with many medications including painkillers, antibiotics, contraception, and cardiac drugs, so careful management is necessary.

There are approximately 20 drugs that can be used to treat epilepsy. Older drugs, such as carbamazepine (Tegretol*), diazepam (Valium*), and lorazepam (Ativan*), are still used; drugs, such as gabapentin (Neurontin*), levetiracetam (Keppra*), and pregabalin (Lyrica*), are newer options. The specific drug prescribed depends on the type of epilepsy, associated side effects, and effectiveness for the individual.

Surgery

If not responding to drug treatment, surgery can be effective for those who have focal seizures and when the underlying cause of the seizure is known. Special tests are completed pre-surgery to find where the seizure begins, and then localized procedures can be performed to block electrical signals in the brain.

Vagal Nerve Stimulation

A small battery placed in the chest wall is connected to the vagal nerve. When a seizure takes place, the battery sends electrical signals to the brain via the vagal nerve interrupting seizure development.

Ketogenic Diet

This diet is typically used to treat children who have drug resistant epilepsy. The diet is high in fat and low in carbohydrates.

References

Page last updated: August 3, 2014
  • Epilepsy Foundation. (2012). Surgery.
  • Epilepsy Foundation. (2012). Causes of Epilepsy.
  • Epilepsy Foundation. (2012). Seizures.
  • Epilepsy Foundation. (2012). VNS.
  • Epilepsy Foundation. (2012). What is Epilepsy.
  • Epilepsy Foundation. (2012). Ketogenic Diet.
  • Fisher, R. S., van Emde Boas, W., Blume, W., Elger, C., Genton, P., Lee, P., & Engel Jr., J. (2005). Epileptic Seizures and Epilepsy: Definitions Proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE).
  • Welsh, R., & Kerley, S. (2009). Nursing patients with epilepsy in secondary care settings. Nursing Standard.
  • Berg, A. T., Serkovic, S. F., Brodie, M. J., Buchhalter, J., Cross, J. H., van Emde Boas, W., . . . Scheffer, I. E. (2010). Revised terminology and concepts for organization of seizures and epilepsies: Report of the ILAE Commission on Classification and Terminology.
  • Chang, B. S., & Lowenstein, D. H. (2003). Epilepsy. The New England Journal of Medicine.
  • Guerrini, R. (2006). Epilepsy in Children. The Lancet.
  • Duncan, J. S., Sander, J. W., Sisodiya, S. M., & Walker, M. C. (2006). Adult Epilepsy. The Lancet.
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