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Key takeaways
- Epilepsy involves seizures caused by abnormal electrical activity in the brain, with symptoms varying by the areas affected.
- Assessment and treatment are individualized, with medication commonly used and other interventions considered for uncontrolled seizures.
- Knowledgeable support includes protecting the person during seizures and recognizing when emergency assistance is needed.
What Is Epilepsy?
\nEpilepsy is a medical condition that causes seizures. A seizure is a burst of abnormal electrical activity in the brain. (1) Every time someone with epilepsy has a seizure, that burst of electrical activity disrupts normal communication in the nervous system, leading to a wide variety of symptoms. Some people experience generalized seizures, which affect both sides of the brain, while others experience focal seizures, which affect just one part of the brain.\n
The World Health Organization estimates that about 5 million people are diagnosed with this condition each year, affecting 50 million people at any given time. (2) In the United States, approximately 1.2% of the population has epilepsy. (3) Adults account for most cases, but the seizure disorder also affects nearly 500,000 American children.
\nEpilepsy can be active or dormant. An adult with the active version has been diagnosed by a healthcare professional and meets at least one of the following criteria:\n
- \n
- Taking medication to control their symptoms \n
- Had at least one seizure within the past year \n
\nAdults with dormant epilepsy have received a diagnosis at some point in their lives, but they're not taking medication to control it, and they haven't had a seizure within the past year. (4)
What Causes Epilepsy?
\nIn some cases, epilepsy develops due to the presence of another medical condition, such as stroke, brain tumors, or brain damage caused by a traumatic injury. Hemorrhagic strokes occur when one of the blood vessels in the brain bursts, while ischemic strokes occur when a blood clot blocks blood flow to the brain. (5) Both events can interfere with normal electrical activity, which may trigger seizures.\nAs brain tumors get larger, they can press on some of the structures in the brain. This causes the nerve cells to fire excessively, disrupting normal communication. (6) In some people, this leads to the development of epilepsy or another seizure disorder. Traumatic brain injuries occur when someone hits their head or has an object penetrate their head. For example, a bullet that penetrates the skull can cause a traumatic brain injury. Like strokes and tumors, these injuries can disrupt communication between the nerve cells, causing epilepsy.\nEpilepsy also occurs in people with neurotransmitter imbalances. (7) A neurotransmitter is a chemical that helps the brain and other parts of the nervous system communicate with each other. In some people, the condition has no obvious underlying cause, making it more difficult to manage.\n
What Are Epilepsy Symptoms?
\nEpilepsy causes several types of seizures. The symptoms of a seizure depend on what type it is, where in the brain it occurs, and how much of the brain is affected. Focal seizures, also known as partial seizures, sometimes start out with an aura, which causes fear, a feeling of déjà vu, a sense of impending doom, or feelings of euphoria. Other symptoms of a focal seizure include nausea, sweating, loss of consciousness, and changes in behavior.\nSomeone with epilepsy may experience the following types of generalized seizures:\n
- \n
- Absence seizures: During an absence seizure, the person stares blankly for around 30 seconds. These staring episodes are caused by an altered state of consciousness. \n
- Tonic-clonic seizures: Also known as grand mal seizures, generalized tonic-clonic seizures cause the arms and legs to flex, expand, and shake. Then the muscles contract and relax before the person enters a postictal state. During the postictal state, which lasts approximately 5 to 30 minutes, the individual may feel confused, drowsy, or nauseated. (8) Some people also experience headaches or elevated blood pressure. \n
- Atonic seizures: An atonic seizure causes the sudden loss of muscle tone. When this occurs, the individual drops their head or falls from a standing position. \n
- Myoclonic seizures: A myoclonic seizure is characterized by sudden jerking or quick movements of the muscles. \n
How Is Epilepsy Diagnosed?
\nEpilepsy is typically diagnosed with a neurological exam and an electroencephalogram (EEG). (9) During a neurological exam, a doctor or other healthcare professional asks questions about the patient's epilepsy symptoms and medical history. They also check the person's reflexes, evaluate their coordination, and assess their mental functioning. (10)\nAn EEG assesses the electrical activity in the brain. During this test, a technician places electrodes on the scalp. These electrodes capture electrical impulses and turn them into a graph that a healthcare provider can interpret. (11)\n
How Is Epilepsy Treated?
\nThe most common type of epilepsy treatment is medication. Many people have to try more than one drug before they find one that works well to prevent seizures. In some cases, it's necessary to combine two or more epilepsy medications for adequate symptom control. Neuromodulation uses a special device to send electrical currents to the nervous system. These impulses help the brain function normally, which may prevent seizures. (12)\nPeople with uncontrolled seizures may need surgery to manage their symptoms. Many of these surgeries involve removing a portion of the brain tissue to prevent excessive firing of the nerve cells. (13)\n
How to Cope With an Epilepsy Diagnosis
\nA new epilepsy diagnosis can be stressful, especially if the symptoms interfere with work, school, or family relationships. Attending mental health therapy can be helpful for coming to terms with the diagnosis and finding ways to cope with the lifestyle changes necessary to get epilepsy symptoms under control.\nIt's also important for an individual with epilepsy to focus on their health. Drinking plenty of water, eating nutritious foods, avoiding alcohol, and getting enough sleep every night can all make it easier to manage this condition. People who take medication to prevent seizures should take their medicine exactly as prescribed.\n
How to Help Someone With Epilepsy
\nOne of the best ways to support a person with epilepsy is to learn what to do during a seizure. Staying calm, speaking to the individual in a soothing tone of voice, and knowing when to get emergency medical help are all important. Once a seizure ends, loved ones can also help by asking the person questions and making sure they feel safe.\nIt's also important to know what not to do during and after a seizure. Bystanders should never hold down a person having a seizure, try to put something in their mouth, or attempt CPR. (14) Attending doctors' appointments can be a great way to learn more about epilepsy and how to effectively support someone with this diagnosis.
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