Epilepsy

What is epilepsy?

Epilepsy is a neurological condition that causes unprovoked, recurrent seizures. A seizure is a sudden rush of abnormal electrical activity in your brain. Doctors diagnose epilepsy when you have two or more seizures more than 24 hours apart with no other identifiable cause. Epilepsy affects 50 million people around the world, according to the World Health Organization (WHO).

Anyone can develop epilepsy, but it most commonly onsets in young children and older adults. According to research published in 2021, men develop epilepsy more often than women, possibly because of higher exposure to risk factors like alcohol use and head trauma.

What are the myths about epilepsy?

Epilepsy is not contagious. There is a hereditary component, but it’s not spread by associating with people with epilepsy or if you come into contact with the person’s saliva. There is a misconception that once the person falls into water or fire then the disease cannot be controlled. People with epilepsy may have some intellectual disabilities however when seizures are managed on medications, person can live a relatively normal life.

What causes epilepsy?

In about half of people with epilepsy, the cause cannot be determined, per the WHO. A variety of factors can contribute to the development of seizures, such as:

• Traumatic brain injury or other head trauma
• Brain scarring after a brain injury (post-traumatic epilepsy)
• Serious illness or very high fever
• Stroke, which causes about half of epilepsy cases in older adults when there’s no identifiable cause, according to the CDC
• Lack of oxygen to the brain
• Brain tumor or cyst
• Dementia, including Alzheimer’s disease
• Use of certain medications or hard drugs when mother was pregnant, prenatal injury, brain malformation, or lack of oxygen at birth
• Infectious conditions like HIV and AIDS and meningitis
• Genetic or developmental disorders or neurological diseases

What are the symptoms of epilepsy?

Seizures are the main symptom of epilepsy. Symptoms differ from person to person and according to the type of seizure.

Focal (partial) seizures

A focal aware seizure (previously called simple partial seizure) does not involve loss of consciousness. Symptoms include: alterations to sense of taste, smell, sight, hearing, or touch, dizziness, tingling and twitching of limbs. Focal unaware seizures (previously called complex partial seizures) involve loss of awareness or consciousness. Other symptoms include: staring blankly, unresponsiveness, performing repetitive movements.

Generalized seizures involve the whole brain

Sub-types include:

• Absence seizures. Absence seizures used to be called “petit mal seizures.” They tend to cause a short loss of awareness, a blank stare, and may cause repetitive movements like lip smacking or blinking.
• Tonic seizures. Tonic seizures cause sudden stiffness in the muscles in your legs, arms, or trunk.
• Atonic seizures. Atonic seizures lead to loss of muscle control. They’re also called “drop seizures” because a sudden loss of muscle strength can make you fall suddenly.
• Clonic seizures. Clonic seizures are characterized by repeated, jerky muscle movements of the face, neck, and arms.
• Myoclonic seizures. Myoclonic seizures cause spontaneous quick twitching of the arms and legs. Sometimes these seizures cluster together.
• Tonic-clonic seizures. Tonic-clonic seizures used to be called “grand mal seizures.” And the person may have stiffening of the body, shaking, loss of bladder or bowel control, biting of the tongue and loss of consciousness

How can epilepsy be detected?

To diagnose epilepsy, other conditions that cause seizures should be ruled out. A doctor will probably order a full blood count (FBC) and chemistry of your blood. Blood tests may be used to look for:

• Signs of infectious diseases
• Liver and kidney function
• Blood glucose levels

Electroencephalogram (EEG) is the most common test used to diagnose epilepsy. It’s a noninvasive and painless test that involves placing electrodes on your scalp to search for abnormal patterns in your brain’s electrical activity. A Computed Tomography Scan (CT Scan) or Magnetic Resonance Imaging (MRI) can also be done. Epilepsy is usually diagnosed if you have seizures, but there’s no apparent or reversible cause.

How is epilepsy treated?

Treatment for epilepsy may help you have fewer seizures or stop seizures completely. Some treatment options include:

• Anti-epileptic (anticonvulsant, antiseizure) drugs. Anti-epileptic medications can help reduce the number of seizures you have. In some people, they may eliminate seizures. To be most effective, the medication must be taken exactly as your doctor prescribed.
• Brain surgery. The area of the brain that causes seizure activity can be removed or altered if you and your healthcare team determine it’s the right treatment for your condition.

What can you do to help someone having epilepsy?

If the person is having a tonic-clonic seizure, which causes uncontrolled shaking or jerking:

• Ease the person to the ground.
• Turn them gently onto their side to help them breathe.
• Clear any dangerous objects away from them.
• Put something soft under their head, like a pillow
• If they wear glasses, remove them.
• Loosen any clothing, such as a tie, that may affect breathing.

When someone is having a seizure, it’s critical to never:

• Hold the person down or try to stop their movements
• Put anything in their mouth not even a metallic spoon
• Give them mouth to mouth
• Offer the person food or water until they’re fully alert

People living with epilepsy require support from family, friends and community and all efforts should be made to avoid stigmatizing them.