Epilepsy is a central nervous system (neurological) disorder in which brain activity becomes abnormal, causing seizures or periods of unusual behavior, sensations and sometimes loss of awareness. Anyone can develop epilepsy. Epilepsy affects both males and females of all races, ethnic backgrounds and ages.
The main symptom of epilepsy is recurrent seizures. However, if a person experiences one or more of the following symptoms, they should seek medical attention, as it may indicate epilepsy:
- a convulsion with no fever
- short blackouts or confused memory
- intermittent fainting spells, during which they lose bowel or bladder control, frequently followed by extreme tiredness
- temporary unresponsiveness to instructions or questions
- sudden stiffness for no apparent reason
- sudden falling for no apparent reason
- sudden bouts of blinking without apparent stimuli
- sudden bouts of chewing without any clear reason
- temporarily seeming dazed and unable to communicate
- repetitive movements that seem involuntary
- fearfulness for no apparent reason
- panic or anger
- peculiar changes in senses, such as smell, touch, and sound
- jerking arms, legs, or body, which will appear as a cluster of rapid jerking movements in babies
It is vital to seek consultation with a doctor if any of these symptoms occur repeatedly.
The following conditions may cause similar symptoms to those above, so some people can mistake them for those of epilepsy:
- high fever with epilepsy-like symptoms
- fainting
- narcolepsy, or recurring episodes of sleep during the day
- cataplexy, or periods of extreme muscle weakness
- sleep disorders
- nightmares
- panic attacks
- fugue state, a rare psychiatric condition in which a person forgets details about their identity
- psychogenic seizures, or seizures with a psychological or psychiatric cause
There is currently no cure for most types of epilepsy.
A doctor may prescribe antiepileptic drugs (AEDs) to help prevent seizures. If these drugs do not work, some other potential options include surgery, vagus nerve stimulation, or a special diet.
Doctors’ objective is to prevent further seizures. They also aim to prevent side effects so that the person can lead an active and productive life.
AEDs
AEDs appear to help control seizures in around 60–70% of cases, according to the American Epilepsy Society. The type of seizure a person has will decide which specific drug the doctor will prescribe.
- valproic acid
- carbamazepine
- lamotrigine
- levetiracetam
It is important to note that some drugs may prevent seizures in one person but not in another. Also, even when a person finds the right drug, it may take some time to find the ideal dosage.
Surgery
If at least two medications have been ineffective in controlling seizures, a doctor may consider recommending epilepsy surgery. A 2013 study from Sweden found that 62% of adults and 50% of children with epilepsy had no seizures for around 7 years after epilepsy surgery.
- Lobectomy: During this procedure, a surgeon will remove the section of the brain in which seizures start. This is the oldest type of epilepsy surgery.
- Multiple subpial transection: During this procedure, a surgeon will make several cuts to limit seizures to one part of the brain.
- Corpus callosotomy: A surgeon will cut the neural connections between the two halves of the brain. This prevents seizures from spreading from one side of the brain to the other.
- Hemispherectomy: In extreme cases, a surgeon may need to cut out a hemisphere, which is one half of the cerebral cortex of the brain.
For some people, undergoing surgery may reduce the frequency and severity of their seizures. However, it is often important to continue taking antiseizure medication for several years following the procedure.
Another surgical option is the implantation of a device in the chest to stimulate the vagus nerve in the lower neck. The device sends preprogrammed electrical stimulation to the brain to help reduce seizures.
Diet
Diet may play a role in reducing seizures. High fat, low carbohydrate diets could benefit children and adults with epilepsy.
Five of the studies in the review used the ketogenic diet, while another five used a modified Atkins diet. Typical foods in these diets include eggs, bacon, avocados, cheese, nuts, fish, and certain fruits and vegetables.
The review found that 32% of study participants adhering to the ketogenic diet and 29% of those following the modified Atkins diet experienced at least a 50% drop in the regularity of seizures. However, many participants had difficulty maintaining these diets.
Specific diets may be beneficial in some cases, but more research is needed to confirm this.
Messaging systems in the brain control every function in the human body. Epilepsy develops due to a disruption in this system, which may result from brain dysfunction.
In many cases, healthcare professionals will not know the exact cause. Some people inherit genetic factors that make epilepsy more likely to occur. Other factors that may increase the risk include:
- head trauma, such as from a vehicle accident
- brain conditions, including stroke and tumors
- infectious diseases, such as viral encephalitis
- cysticercosis
- AIDS
- prenatal injury or brain damage that occurs before birth
- developmental conditions, including autism and neurofibromatosis