If we see someone close to us suddenly having a seizure, shaking, and falling down unconscious, we all get very scared, don't we? It is indeed a scary thing. But if we are properly informed about this condition, it gives us great strength to help that person and to live with this medical condition. So today, let's talk about epilepsy, commonly known by many as a seizure disorder.
What is Epilepsy? Let’s Understand it Simply!
Simply put, epilepsy is a chronic medical condition. It is characterized by recurrent seizures (seizures) caused by abnormal electrical activity in the brain cells. Think of our brain cells as tiny light bulbs. They work together in a specific electrical pattern. However, in the brain of someone with epilepsy, this electrical process is suddenly disrupted, producing uncontrolled electrical energy like a sudden lightning storm. That is when a seizure occurs. This can cause changes in your consciousness, muscle control (such as shaking of limbs), sensations, emotions, and behavior. It is also referred to as a seizure disorder.
Who Can Get Epilepsy?
Actually, anyone, at any age, regardless of gender or ethnicity, can develop epilepsy. So it is difficult to think "it won't happen to me."
How Common Are Seizures Globally?
In the US alone, about 3.4 million people have epilepsy. That means about 3 million adults and 470,000 children. Looking worldwide, about 65 million people suffer from this condition. So, this is not all that uncommon.
What Actually Happens Inside the Brain During a Seizure?
The cells in our brain are responsible for sending and receiving messages throughout the body. These messages travel like electricity along wires, as electrical impulses from one cell to another. In epilepsy, this smooth, rhythmic electrical pattern is disrupted. Instead, there is a sudden burst of electrical energy between cells in one or more areas of the brain, much like an unexpected lightning storm. This electrical disturbance causes loss of consciousness, changes in sensation and emotion, and uncontrolled muscle movements.
What are the Types of Seizures and Their Symptoms?
Doctors classify epilepsy based on the nature of the seizures. This classification depends on where the seizure starts in the brain, your level of awareness during the seizure, and whether there are muscle movements.
There are two main categories of seizures:
1. Focal Onset Seizures
These seizures start in a specific area or network of cells on one side of the brain. They were previously called `partial onset seizures`. There are two types:
- Focal onset aware seizure: You remain conscious and aware of what is happening. This was previously called a `simple partial seizure`. Symptoms can include:
- Changes in your sensations – changes in how things taste, smell, or sound.
- Changes in emotions.
- Uncontrolled muscle jerking, usually in the arms or legs.
- Sensations like seeing flashing lights, feeling dizzy, or experiencing numbness.
- Focal onset impaired awareness seizure: Your consciousness is altered, or you may lose consciousness completely. This was previously called a `complex partial seizure`. Symptoms can include:
- Staring blankly into space.
- Repetitive movements such as blinking, smacking lips, chewing motions, or rubbing hands.
2. Generalized Onset Seizures
These seizures affect networks of cells on both sides of the brain simultaneously. There are six main types:
- Absence seizures: These involve staring blankly, which means a temporary loss of consciousness. There may be minor muscle movements like eye blinking, lip smacking, or hand gestures. These are more common in children and last only a few seconds (usually less than 10 seconds). They are often mistaken for daydreaming. Previously, these were called `petit mal seizures`.
- Atonic seizures: `Atonic` means a loss of muscle tone. During these seizures, you lose muscle control or become weak. Your eyelids or head may droop, or you may suddenly fall to the ground. These are also short (usually less than 15 seconds) and are also called "drop seizures" or "drop attacks".
- Tonic seizures: `Tonic` refers to muscle stiffening. During these, your muscles suddenly stiffen, as if you are frozen. The arms, legs, back, or entire body may stiffen, causing you to fall. During these brief seizures (usually less than 20 seconds), you may remain conscious or experience a slight change in awareness.
- Clonic seizures:`Clonus` refers to rapid, rhythmic muscle contraction and relaxation (jerking). The muscles jerk repeatedly for several seconds to a minute, or they stiffen first and then jerk for several seconds to two minutes.
- Tonic-clonic seizures: This is the type most people picture when they think of a "seizure." It combines muscle stiffening (tonic) and repetitive jerking (clonic). Doctors also call this a `convulsion`, and it was previously known as a `grand mal seizure`. It involves loss of consciousness, falling to the ground, and muscle stiffening and jerking for one to five minutes. Biting the tongue, drooling, or loss of bladder and bowel control may also occur.
Imagine your friend Kamal suddenly screams and falls to the ground. Then his entire body stiffens, followed by rapid shaking of his arms and legs. He foams at the mouth, and when he regains consciousness, he might have involuntarily wet himself. That is the typical presentation of a tonic-clonic seizure.
- Myoclonic seizures: These involve sudden, brief muscle jerks or twitches, like receiving an electric shock (`myo` means muscle, `clonus` means jerking). They usually last only a few seconds.
Are There Specific Seizure Triggers?
Yes, there are certain events or factors that can trigger a seizure. These are called seizure triggers.
Commonly reported triggers include:
- Stress.
- Sleep issues – such as lack of sleep, poor sleep quality, fatigue, disrupted sleep, or sleep disorders like `(Sleep apnea)`
- Alcohol use, alcohol withdrawal, or drug use.
- Hormonal changes, especially those related to a woman's menstrual cycle.
- Illness or fever.
- Flashing lights or patterns.
- Poor diet, dehydration, vitamin or mineral deficiencies, or skipping meals.
- Overexertion.
- Certain foods (caffeine is a common trigger).
- Dehydration.
- Specific times of day or night.
- Certain medications. Ingredients like `(Diphenhydramine)` found in some cold, allergy, and sleep aids have been reported as triggers.
- Missing doses of seizure medication.
How Do I Find My Seizure Triggers?
Some people notice that their seizures occur at a specific time of day or in connection with a specific event. You can keep a seizure diary. Write down the time of the seizure, any specific events happening around that time, and how you felt. If you suspect something is a trigger, verify it. For example, if you think caffeine is a trigger, note if a seizure occurs every time you have caffeine, or only after a certain amount, or at a certain time of day. Careful observation might reveal it isn't actually a trigger.
What are the Signs and Symptoms of an Epileptic Seizure?
The main symptom of epilepsy is recurrent seizures. However, symptoms vary depending on the type of seizure you experience.
Common signs and symptoms:
- Temporary confusion or loss of consciousness.
- Uncontrolled muscle movements, jerking, or loss of muscle tone.
- Staring blankly into space.
- Temporary cognitive changes, slow thinking, or difficulty speaking and understanding.
- Changes in senses such as hearing, vision, taste, smell, or sensations of numbness or tingling.
- Difficulty speaking or understanding speech.
- Upset stomach, feeling hot or cold, or goosebumps.
- Repetitive movements like lip smacking, chewing, rubbing hands, or picking at fingers.
- Psychological symptoms such as fear, panic, anxiety, or déjà vu (a feeling that something has happened before).
- Increased heart rate and/or breathing rate.
Most people with epilepsy tend to have the same type of seizure each time, so their symptoms will be similar from episode to episode.
What are the Causes of Epilepsy?
In most cases (about 70%), a specific cause cannot be identified. Known causes include:
- Genetics: Some epilepsy types (e.g., `(juvenile myoclonic epilepsy)`, `(childhood absence epilepsy)`) can run in families. Researchers believe that while certain genes increase the risk of epilepsy, other factors are also involved.
- Mesial temporal sclerosis: A scar in the inner part of the temporal lobe near the ear, which can cause focal seizures.
- Head injuries: From car accidents, falls, or any blow to the head.
- Brain infections: Such as `(brain abscess)`, `(meningitis)`, `(encephalitis)`, and `(neurocysticercosis)`.
- Immune disorders: Conditions where the immune system attacks brain cells (`(autoimmune diseases)`).
- Developmental disorders: Brain abnormalities present at birth are a common cause, especially in drug-resistant cases (e.g., `(focal cortical dysplasia)`, `(polymicrogyria)`, `(tuberous sclerosis)`).
- Metabolic disorders: Issues with how the body processes energy.
- Brain diseases and blood vessel abnormalities: `(brain tumors)`, `(strokes)`, `(dementia)`, and blood vessel malformations like `(arteriovenous malformations)`.
How is it Diagnosed?
Technically, if you have had two or more unprovoked seizures (meaning not caused by temporary conditions like alcohol withdrawal or low blood sugar), you are considered to have epilepsy.Before making a diagnosis, your doctor (or an epilepsy specialist) will perform a physical exam, take your medical history, and run blood tests (to rule out other causes). They will ask about your symptoms during the seizure and may perform other tests.
Your doctor may ask you or family members who witnessed the seizure:
- Did the muscles jerk?
- Did the muscles stiffen?
- Was there loss of bowel or bladder control?
- Were there changes in breathing?
- Did the skin turn pale?
- Did you stare blankly?
- Did you lose consciousness?
- Was it difficult to talk or understand?
What Tests are Used to Diagnose This?
The main tests are:
- EEG (Electroencephalography): Measures the electrical activity of the brain. Certain abnormal patterns are associated with seizures.
- Brain scans: Tests like `(Magnetic Resonance Imaging - MRI)` are used to check for brain tumors, infections, or blood vessel abnormalities.
What Treatments are Available for Epilepsy?
Treatments for managing epilepsy include anti-seizure medications, dietary therapies (usually alongside medication), and surgery.
Anti-seizure medications
These medications can control seizures in 60% to 70% of people with epilepsy. This treatment is highly individualized. The US FDA has approved more than 20 medications for treating epilepsy. Your doctor may try different medications to find the right drug, dose, or combination for you.
When choosing a medication, doctors consider:
- The type of seizures.
- How you responded to previous seizure medications.
- Other medical conditions you have.
- Potential drug interactions with other medications you take.
- Side effects of the seizure medication.
- Your age.
- Overall health.
- Cost.
Important: Some anti-seizure medications can be harmful to a developing baby during pregnancy. If you are pregnant or planning to become pregnant, be sure to inform your doctor.
If medications do not control seizures and they are severe, your doctor may consider surgery.
Diet therapy
The ketogenic diet and the modified Atkins diet—both of which are high-fat, moderate-protein, and low-carbohydrate diets—are recommended for some people with epilepsy. These are most commonly recommended for children who do not respond to medication and are not candidates for surgery. A low glycemic index diet may also help reduce seizures in some individuals.
Surgery and devices
If medications do not control seizures and they are severe, your doctor may consider surgery. If seizures are not controlled after trying two different medications, epilepsy surgery can be a safe and effective treatment. It is important to be evaluated at an epilepsy center to see if you are a candidate for surgery.
Surgical options include removing abnormal tissue (surgical resection), cutting fibers that connect parts of the brain (disconnection), stereotactic radiosurgery (destroying abnormal brain tissue using targeted radiation), or implanting neuromodulation devices. These devices send electrical impulses to the brain to reduce seizures over time.
Can Epilepsy Be Prevented?
While many causes of epilepsy are beyond our control, you can reduce your risk of developing conditions that lead to epilepsy:
- Reduce the risk of traumatic brain injury (TBI): Always wear a seatbelt, drive safely, wear a helmet when cycling, keep floors clear of hazards to prevent falls, and avoid climbing unstable ladders.
- Reduce the risk of stroke: Eat a healthy diet (like a Mediterranean diet), maintain a healthy weight, and exercise regularly.
- Seek treatment for substance abuse. Alcohol and illegal drugs can damage the brain, potentially leading to epilepsy.
Is There a Cure for Epilepsy?
No, there is currently no cure for epilepsy. However, there are many treatment options available to manage it.
Will I Have Seizures Forever?
With proper treatment, about 70% of people become seizure-free within a few years. The remaining 30% are considered to have drug-resistant epilepsy. These individuals should be evaluated at an epilepsy center to see if they are candidates for epilepsy surgery.
How Long Will I Need to Take Seizure Medication?
This depends on the type of epilepsy you have and how well you respond to treatment. Some people who remain seizure-free for several years may be able to stop taking medication. This decision must be made by your doctor. They will consider various factors, including the absence of brain lesions on MRI, EEG results, and your medical history. Some individuals may need to take medication for life.
When Should I Consult a Doctor? When Should I Go to the Emergency Department?
If you have never had a seizure before and suspect you experienced one—or if others tell you that you stared blankly or lost consciousness—consult your family doctor. They can refer you to a neurologist for further evaluation.
Emergency! If you experience a seizure that lasts longer than five minutes, or if you have multiple seizures in a row without regaining consciousness, call 911 immediately (or have someone nearby call 911).
How Do I Manage My Seizures?
The following steps can help you manage your epilepsy:
- Take your medication exactly as prescribed by your doctor. If you miss a dose, contact your doctor immediately.
- Get adequate sleep (usually 7 to 9 hours per night).
- Manage stress. Stress releases certain chemicals in brain regions susceptible to seizures. Try yoga, meditation, deep breathing exercises, biofeedback, or other relaxation techniques to reduce stress.
- Exercise regularly (about 30 minutes a day, 5 days a week).
- Avoid excessive alcohol consumption.
- Inform all your doctors that you have epilepsy. If another doctor prescribes medication for a different condition, consult your neurologist. Certain drugs, such as antidepressants, antihistamines, and stimulants, can interfere with seizure medications or cause side effects.
- Always tell your neurologist about everything you take—including over-the-counter medications, vitamins, supplements, and traditional remedies.
- Identify and avoid your seizure triggers.
- Eat a healthy diet.
Can I Drive If I Have Epilepsy?
In the United States, a medical evaluation and doctor's clearance are required when obtaining or renewing a driver's license if you have a history of epilepsy or seizures. Ask your doctor if it is safe for you to drive.Generally, you should not drive until your seizures are well-controlled.
What are the Life-Threatening Complications of Epilepsy?
Seizures can lead to serious physical injuries. Additionally, life-threatening conditions associated with epilepsy include status epilepticus and Sudden Unexpected Death in Epilepsy (SUDEP).
Status epilepticus
This is a seizure that lasts for a long time (5 to 30 minutes) or a series of seizures where the person does not regain consciousness in between. This is a medical emergency.
Emergency hospital treatments include:
- Administering medications, oxygen, and intravenous fluids.
- Inducing a medical coma using anesthetics to stop the seizures.
- EEG monitoring to assess response to treatment.
- Tests to identify the cause of the seizures.
Sudden Unexpected Death in Epilepsy (SUDEP)
`SUDEP` is a rare condition where an otherwise healthy person with epilepsy dies suddenly without an obvious cause. It most often occurs during sleep or at night. Researchers believe potential causes include:
- Irregular heartbeats: Seizures can cause serious heart rhythm problems or cardiac arrest.
- Breathing difficulties: If breathing stops (e.g., due to sleep apnea), the lack of oxygen to the brain and heart is life-threatening. Also, a convulsive seizure can block the airway, causing suffocation.
- Aspirating vomit: Inhaling vomit during or after a seizure can block the airway.
- Disrupted brain function: Seizures can disrupt brain regions that control breathing and heart rate.
About 1 in 1000 people with epilepsy die from SUDEP each year. This is the leading cause of death in people with uncontrolled seizures. To lower your risk, identify and avoid triggers, take your medication exactly as prescribed, and practice healthy habits (get enough sleep, exercise, eat well, avoid smoking, and limit alcohol and drug use).
What is the Difference Between "Convulsion", "Seizure", and "Epilepsy"?
- Convulsion: Involves uncontrolled muscle shaking and altered consciousness. Many people use "convulsion" and "seizure" interchangeably, or use "convulsion" to refer to a tonic-clonic seizure.
- Seizure: Caused by abnormal electrical activity in brain cells. You can have a seizure without any external symptoms, which doctors call an `EEG seizure`. Usually, seizures present with the various symptoms mentioned above. A seizure is a symptom of epilepsy, but not all seizures are caused by epilepsy.
- Epilepsy: A neurological disorder characterized by recurrent, unprovoked seizures. Epilepsy can be a lifelong condition.
Finally, Remember These Key Points!
Epilepsy is not as uncommon as you might think; many people worldwide live with it. The most important thing is that it can be managed.
Remember, you are not alone. With proper medical care, positive lifestyle changes, and support from loved ones, you can live successfully with this condition.
- If you or someone you know has epilepsy, follow professional medical advice.
- Take your medication on time.
- Identify and avoid your seizure triggers.
- Prioritize sleep, a healthy diet, and stress management.
- Never lose hope. New treatment options are constantly emerging as medical technology advances.
If you have more questions, talk to your doctor. They are always ready to help!
👩🏽⚕️ Frequently Asked Questions (FAQs)
💬 Is epilepsy a form of demonic possession or a mental illness?
Absolutely not! It is a medical condition caused by a temporary disruption, similar to a short circuit, in the electrical signals of the brain's nerves. This electrical storm causes involuntary shaking and loss of consciousness. It is purely a neurological medical condition and not related to any supernatural or mystical forces.
💬 Does everyone who experiences a seizure have epilepsy?
No. Children can experience seizures due to high fever (febrile seizures), and they can also occur due to very low blood sugar levels. These are not classified as epilepsy. Epilepsy is diagnosed medically only when a person experiences at least two unprovoked seizures occurring more than 24 hours apart.
💬 Is it correct to place an iron object in a person's hand during a seizure?
This is one of the most common myths! Placing an iron object (like keys) in the hand or pouring water into the mouth of someone having a seizure does not help at all. In fact, pouring water can cause aspiration into the lungs, which can be fatal. The best thing to do is to gently roll the person onto their side, loosen tight clothing around their neck, and keep them safe until the shaking stops.
` epilepsy, seizure, fits, brain disorders, neurological disorders, treatment
