EPILEPSY

(Seizure Disorder)

 Basic information

description

Epilepsy is a brain disorder involving recurrent seizures of all types. Seizures are episodes of disturbed brain function that cause changes in attention and/or behavior. Epilepsy affects both sexes and all ages. It often begins between ages 2 and 14. The two main categories of seizures are generalized seizures (the whole brain is involved) and partial seizures (a limited area of the brain is involved). Each category has different seizure types.

FREQUENT SIGNS & SYMPTOMS

• Generalized seizures types:
  • Tonic-clonic (grand mal)—complete loss of consciousness, falling, jerking movements, urine loss.
  • Absence (petit mal)—brief loss of consciousness.
  • Myoclonic— brief jerking movements.
  • Atonic—abrupt loss of muscle tone (can lead to falls).
• Partial seizures types:
  • Simple partial—stays conscious; weakness, numbness, unusual smells or tastes, muscle twitching, turning head to side, visual changes, or vertigo may occur.
  • Complex partial—altered consciousness, automatic repetitive behavior, uncontrolled laughing, unusual thoughts, hallucinations, fears, or smells odd odors.

causes

Abnormal changes in how the cells in the brain send signals to each other. The causes are often unknown.

risk increases with

• Family history of seizure disorders.
• Head injury (such as from accidents).
• Stroke and other vascular diseases.
• Brain infections (such as meningitis) or brain tumor.
• Prolonged seizures in childhood due to high fevers.

PREVENTIVE MEASURES

• No specific preventive measures.
• Prevent head injuries by using seatbelts in motor vehicles. Wear correct headgear for any activity where head injury is a risk.
• Prevent strokes by living a healthy lifestyle.

expected outcomes

There is no cure. Treatment can prevent most seizures and allow a near-normal life.

possible complications

• Seizures continue despite treatment.
• Risk of injury if seizure occurs while driving or operating equipment or swimming or other activity.
• For some patients, epilepsy carries a stigma. It can lead to emotional problems, difficulty in social and family relationships, and problems in finding employment.
• Status epilepticus (a prolonged seizure state).
• Sudden, unexpected death (rare).

 diagnosis & treatment

general measures

• Your health care provider will do a physical exam. Medical tests usually include blood studies; one or more types of brain scans; and electroencephalogram (EEG), a study of the brain's electrical activity.
• Treatment for epilepsy usually involves drug therapy.
• Vagus nerve stimulation may be an option. A device implanted in the neck provides mild electrical stimulation to the vagus nerve to help control seizures.
• Surgery may be helpful in a few cases. An area of the brain causing seizures may be removed, or certain nerve pathways in the brain may be interrupted.
• Seizures may result from too little sleep, stress, not taking your drugs, menstrual periods, or flashing lights.
• Wear a medical-alert type bracelet or pendant that shows you have epilepsy (in case you have a seizure).
• To learn more: Epilepsy Foundation of America, 8301 Professional Dr., Landover, MD 20785; (800) 332-1000; website: www.efa.org.
• If you observe a seizure: keep yourself calm, loosen person's neckwear, help him or her lay on one side, put something soft under the head, and protect him or her from injury. Stay with person until seizure is over.

medications

Anticonvulsant drugs will usually be prescribed. Dosage changes are often needed. If a person is seizure-free for 2 or more years, drug withdrawal may be considered.

activity

No limits. Most states allow persons with epilepsy to drive a vehicle after being seizure-free for 1 year.

diet

• Usually no special diet. Alcohol use may be limited.
• A ketogenic diet may be suggested in certain cases.

 notify our office if

• You or a family member has symptoms of epilepsy.
• Drugs used in treatment produce unusual side effects.
• The pattern of seizure activity changes.
• Call 911 (emergency) if the seizure is prolonged, or other symptoms occur that require emergency care.

Special Notes: