Epilepsy affects a significant number of individuals around the world. While epilepsy may seem confusing or strange to those who have never experienced it, it is a real and daily challenge for those who live with it. This guide aims to shed light on what epilepsy is, epilepsy symptoms, epilepsy causes, and its treatments.
What Is Epilepsy and its Symptoms?
Epilepsy disease is a neurological condition characterized by recurring seizures, caused by a sudden burst of electrical activity in the brain. Seizures can affect people differently, depending on the part of the brain involved.
Here are some of the common types of epilepsy symptoms:
- Simple partial (focal) seizures or "auras"
- These seizures cause strange feelings or sensations, such as a feeling of déjà vu, unusual smells or tastes, tingling in the arms and legs, or an intense feeling of fear or joy.
- People remain awake and aware during simple partial seizures.
- Complex partial (focal) seizures
- During a complex partial seizure, people lose their sense of awareness and make random movements such as smacking their lips, rubbing their hands, making noises, or fidgeting with objects.
- They will not be able to respond to others and will not have any memory of the seizure.
- Tonic-clonic seizures
- Tonic-clonic seizures occur in two stages: the tonic stage, where the person loses consciousness and their body becomes stiff, and the clonic stage, where the limbs jerk, bladder or bowel control may be lost, and breathing may become difficult.
- The seizure typically lasts a few minutes, and the person may experience a headache, memory loss, or confusion after it.
- Absence seizures, also known as petit mal seizures, cause the person to lose awareness of their surroundings for a short time. They are most common in children but can occur at any age.
- During an absence seizure, the person may stare blankly into space, look like they are daydreaming, flutter their eyes, or make small jerking movements of their body or limbs.
- These seizures usually last no longer than 15 seconds and the person will not remember them. They can occur several times a day.
- Myoclonic seizures
- Myoclonic seizures cause the body to suddenly twitch or jerk, as if from an electric shock.
- They usually last a fraction of a second and the person remains awake during them.
- Clonic seizures
- Clonic seizures cause the body to shake and jerk, but the person does not become stiff at the start.
- They usually last a few minutes and the person may lose consciousness.
- Tonic seizures
- Tonic seizures cause all the muscles to suddenly become stiff, causing the person to lose balance and fall over.
- Atonic seizures
- Atonic seizures cause all the muscles to suddenly relax, causing the person to fall to the ground.
- These seizures are usually very brief and the person can get up again immediately.
- Status epilepticus
- Status epilepticus refers to seizures that last a long time or a series of seizures where the person does not regain consciousness in between.
- These epilepsy symptoms are a medical emergency and requires immediate treatment.
What is a Seizure?
A seizure is a sudden, temporary alteration in the electrical and chemical activity of the brain. It results from the over-firing of brain cells (neurons), which can cause changes in behavior, movements, sensations, or consciousness.
During a seizure, the normal pattern of electrical activity in the brain becomes disrupted, leading to the release of an excessive number of neurotransmitters, the chemicals that transmit signals between neurons. This causes the neurons to fire rapidly and in an uncontrolled manner. This can result in:
- Convulsions or muscle contractions: This can manifest as twitching, shaking, or convulsions in various parts of the body.
- Altered consciousness: Seizures can result in confusion, drowsiness, loss of awareness, or even loss of consciousness.
- Changes in sensory perception: Some people may experience changes in vision, hearing, taste, or touch during a seizure.
- Emotional and behavioral changes: Seizures can result in sudden changes in mood or behavior, including fear, anger, or happiness.
Seizures can range in duration from just a few seconds to several minutes. After the seizure, some people may feel tired, confused, or experience headache or muscle soreness.
How is Epilepsy Diagnosed?
There are several methods of diagnosing epilepsy disease, including:
- Clinical evaluation: This includes a detailed medical history and physical examination by a neurologist. They will ask about the patient's symptoms, including the type and frequency of seizures, as well as any other medical conditions or family history of epilepsy.
- Electroencephalogram (EEG): This is a test that measures the electrical activity of the brain. A small metal disk is attached to the scalp with electrodes to measure the brain's electrical signals.
- Imaging studies: This may include a computed tomography (CT) scan or magnetic resonance imaging (MRI) scan to look for any structural changes in the brain that may be causing seizures.
- Blood tests: This helps to determine if there is any underlying medical condition, such as an infection, that could be causing seizures.
- Video EEG: This is a test that combines an EEG with video recording. It allows doctors to see what is happening in the brain during a seizure and helps to diagnose the type of epilepsy.
- Neuropsychological testing: This evaluates the patient's cognitive and behavioral functioning and can help to determine the extent to which seizures are affecting the patient's daily life.
- WADA test: This test is used to determine which side of the brain is dominant for language and memory. It is helpful for planning surgical treatment for some forms of epilepsy.
How is Epilepsy Treated?
- Anti-epileptic medications: Anti-epileptic drugs (AEDs) are the most common treatment for epilepsy disease. AEDs work by reducing the likelihood of seizures. Some of the most used AEDs include valproic acid, carbamazepine, phenytoin, lamotrigine, and levetiracetam.
- Surgery: For people with epilepsy who do not respond well to medication, surgery may be an option. Surgery for epilepsy typically involves removing the portion of the brain that is causing seizures.
- Neurostimulation: Deep brain stimulation (DBS) is a neurostimulation technique that involves implanting electrodes in the brain that send electrical impulses to specific areas. DBS has been shown to be effective in reducing seizures in some people with epilepsy.
- Vagus nerve stimulation (VNS): VNS is a procedure that involves implanting a device under the skin of the chest that sends electrical impulses to the vagus nerve in the neck. These impulses are thought to help reduce the frequency of seizures.
Dietary therapy: For some children with epilepsy disease, a ketogenic diet may be recommended. This is a high-fat, low-carbohydrate diet that has been shown to reduce the frequency of seizures in some children.