Understanding Epilepsy: Symptoms, Causes, and Treatment

Epilepsy is a common neurological disorder known for causing recurrent seizures. These seizures happen because the brain’s electrical activity is not normal. The Mayo Clinic says it impacts about 3 million people in the U.S., making it the fourth most common brain condition.¹ Epilepsy leads to a variety of symptoms, such as brief confusion, staring, uncontrollable jerking, or even a loss of consciousness, depending on the seizure type.² Doctors diagnose it with tests like neurological exams, EEGs, and brain scans. To manage it, there are medications, a special diet called the ketogenic diet, surgeries, and therapies like vagus nerve stimulation. Working with a team that includes neurologists and other doctors is often necessary to control epilepsy.

Key Takeaways

Epilepsy is a common neurological disorder affecting around 3 million people in the U.S.
Seizures can cause a wide range of symptoms, from temporary confusion to uncontrollable movements.
Treatment options include medications, specialized diets, surgical procedures, and brain stimulation therapies.
Effective management of epilepsy often requires a team of healthcare professionals.
Understanding the causes and types of seizures is crucial for proper diagnosis and treatment.

What is Epilepsy?

According to the Mayo Clinic and Mayo Clinic Explains Epilepsy video, epilepsy is a long-term (chronic) neurological disorder. It is known for recurring seizures.¹ These seizures happen due to sudden, uncontrolled brain cell activity. This activity messes up the brain’s normal way of sending messages.³

Causes of Abnormal Brain Activity

This abnormal brain activity can occur from damaged brain cells. This leads to unpredictable “electrical storms” or seizures.³ Several things can trigger this abnormality. These include genetic issues, past brain injuries, or developmental disorders. Sometimes, no exact reason can be found.³

Prevalence of Epilepsy

Epilepsy is common, affecting about 3.4 million U.S. residents.⁴ This includes 3 million adults and 470,000 kids.⁵ Mayo Clinic calls it the fourth most common neurological disease in the U.S.⁵ It’s right after migraine, stroke, and Alzheimer’s.⁵ Globally, around 65 million people have epilepsy.⁵ In the U.S., there are about 150,000 new epilepsy cases each year.⁴

Statistics on Epilepsy in the United States

The point prevalence of active epilepsy is 6.38 people per 1,000.⁴ For a lifetime, it’s 7.60 per 1,000.⁴ The yearly cumulative incidence is 67.77 per 100,000.⁴ Across the globe, 50 million have epilepsy, making it a common neurological disease worldwide.⁵

In low and middle income countries, epilepsy rates are higher.⁴ This is true for unknown causes and seizures that affect the whole body.⁴ The numbers don’t change much with different ages, gender, or study quality.⁴

Over 70% of epilepsy cases are in low- and middle-income nations.⁵ With the right treatment, up to 70% could be seizure-free.⁵ Yet, the risk of early death is three times higher for them.⁵ Sadly, three quarters of epilepsy patients in poor nations don’t get treated.⁵

Around 5 million receive an epilepsy diagnosis each year.⁵ In richer nations, this is 49 people for every 100,000.⁵ For poorer areas, that number jumps to 139 out of 100,000.⁵ Most people with epilepsy are in nations with less money.⁵ If treated correctly, up to 70% could stop having seizures.⁵ However, many in low-income areas don’t get the medicine they need.⁵

Less than 50% of cheaper, generic epilepsy meds are easily found in poor and middle-income countries.⁵ Sadly, about a quarter of epilepsy cases could have been avoided.⁵ Epilepsy adds up to more than 0.5% of the world’s health problems.⁵ The costs and work lost because of epilepsy can really hurt families.⁵

Types of Seizures

Epilepsy is a complex issue with seizures happening in patterns. Health experts place seizures into two groups, by their start and symptoms: focal onset and generalized onset.⁶

Focal Onset Seizures

These seizures begin in a certain part of the brain.⁶ They can affect the senses, feelings, and cause twitching or confusion. Some may lead to bigger seizures where the body stiffens and jerks.⁷⁶

Generalized Onset Seizures

In this type, seizures quickly involve both sides of the brain.⁶ Its symptoms vary, such as staring, loss of tone or muscle stiffness. A few people with this issue may pass it on, and it might show up more in their kids.⁷

Some tests might show why these seizures happen. Not sleeping enough or drinking too much can make the risks higher, especially if it runs in the family.⁷

Knowing the seizure type is key for treatment and care. Seeing a specialist or going to an epilepsy center can figure out the best actions.⁶

Symptoms of Seizures

The Mayo Clinic video explains that seizures have many symptoms. It all depends on the type of seizure a person has.¹ For instance, focal onset seizures may make you notice changes in how things taste, smell, or look. These can also affect your feelings. Then, your muscles might start moving on their own. You could feel lost or have staring spells. You might do the same movement over and over.

On the other hand, generalized seizures start in both sides of the brain. They might show up as staring spells, muscles suddenly going weak, or your muscles tightening. You could also experience jerking motions, stiffening and jerking together, or quick muscle jerks.¹ The Second source further explains what each type of generalized seizure looks like. It’s really important to know what kind of seizure it is to treat it right.

Signs of Focal Seizures

Focal seizures start in just one part of the brain. They can make your senses change or make you feel things very strongly. Your muscles might move in ways you can’t control. You could also feel like you’re not there or keep staring. And you might find yourself doing the same thing again and again.¹ It’s key to notice these signs so the right treatment can be given.

Signs of Generalized Seizures

Generalized seizures begin all over the brain. This might cause you to have times where you just stare. Your muscles could suddenly get weak or very tense. They might also start moving in a rhythmic way, or stiffen and jerk together. Sometimes, your muscles might just suddenly jerk.¹ The Second source gives more information about what each kind of generalized seizure looks like.⁸ Knowing these signs is crucial for dealing with epilepsy properly.

Epilepsy and Brain Function

The brain works through a steady electrical impulse. This helps different parts of the brain communicate clearly.⁹ But, in epilepsy, this normal system is disturbed. It causes bursts of uncontrolled energy, or “electrical storms,” in the brain.⁹ This leads to various symptoms like changes in awareness or uncontrolled movements.

How the Brain Works

The brain’s cells communicate with the body through electrical signals.⁹ In epilepsy, this process is messed up. It happens because the brain’s electrical activity is not smooth.⁹

Brain Disruptions in Epilepsy

The brain’s various areas control different functions. When seizures happen, they affect these parts.⁹ For example, memory and language can be affected. Some people might have trouble with thinking.⁹ It’s key to know how epilepsy changes brain communication to diagnose and treat it correctly.

Some seizures can affect planning and the way we interact with others.⁹ Others can impact memory.⁹ Those with certain types of seizures might have less trouble thinking than others.⁹ The impact of seizures on thinking can change. It depends on how long the seizure lasts, the medication, and individual factors.⁹

Studies show that epilepsy can change the brain’s structure. This can lead to trouble with thinking.¹⁰ Certain factors, like age or type of epilepsy, can increase this risk.¹⁰ Scientists have also linked different types of epilepsy to these thinking problems.¹⁰

Study	Findings
Fiest et al. (2016)	Reported on the prevalence and incidence of epilepsy, showing rates of 296-303 cases.¹⁰
Vrinda et al. (2019)	Discussed transient cognitive impairment in epilepsy, pointing towards a specific aspect of cognitive issues in patients.¹⁰
Hermann and Seidenberg (2007)	Highlighted cognitive impairment in epilepsy, emphasizing the impact on cognitive functions.¹⁰
Wang et al. (2020)	Identified factors contributing to cognitive impairment in adult epileptic patients, focusing on demographic and clinical characteristics.¹⁰
Saniya et al. (2017)	Updated neuroanatomical changes in brain structures related to cognition in epilepsy, showing shifts over time.¹⁰
Holmes (2015)	Analyzed cognitive impairment in epilepsy caused by network abnormalities, shedding light on a specific cause of cognitive deficits.¹⁰
Kuks and Snoek (2018)	Referenced cognitive problems related to epilepsy syndromes, focusing on the connection between malignant epilepsies and cognitive complications.¹⁰
Van Rijckevorsel (2006)	Discussed cognitive problems due to epilepsy syndromes, indicating how specific seizure types impact cognitive functions.¹⁰

Diagnosing Epilepsy

Sometimes, diagnosing epilepsy isn’t immediate, even after a suspected seizure.¹¹ The Mayo Clinic says if you think you’ve had a seizure, see a doctor. The doctor will do a neurological exam and order various tests.¹¹ These tests might include blood work, an EEG, CT scans, MRI, and sometimes special brain function tests.¹¹

Medical Tests for Diagnosis

It’s tough to diagnose epilepsy because seizure symptoms can look like other conditions.¹² Knowing the type of seizures helps figure out the right treatment.

The first test is usually an EEG, which checks the brain’s electric signals.¹² Sometimes, longer EEG monitoring is needed, done in a special unit over a couple of days. This helps if the first test doesn’t show anything.¹²

A brain MRI might be next. It shows detailed pictures of the brain’s structure.¹² An fMRI then identifies areas that control things like speech or movement. This is by asking you to do certain tasks during the scan.¹²

After that, a PET scan looks at how your brain uses energy. This test is good for checking for epilepsy and other brain issues.¹² Then, an SPECT scan shows spots with high activity during a seizure. It helps find out what’s causing the seizures by looking at cell activity, blood flow, and brain cell signaling.¹²

Neurological Evaluations

Advanced brain monitoring helps plan for epilepsy surgery.¹² The Wada test helps predict how surgery might affect your memory and language.¹² Neuro-psychological tests check for cognitive issues in epilepsy patients. They focus on memory and brain functions.¹²

It’s tough to diagnose seizures, but get help if you’re having symptoms.¹¹ Specialists do detailed exams to look for brain and nervous system issues.¹¹ EEGs are used because they’re simple and safe. They show if your brain’s electrical patterns are linked to seizures.¹¹ Brain scans like CT or MRI help find any brain problems.¹¹

An epilepsy team includes specialists, nurses, and mental health professionals.¹¹ A correct diagnosis is crucial. Not all seizure-like events are related to epilepsy. They could be caused by other conditions.¹¹

Medication for Epilepsy

Medication is key in treating epilepsy. Over half of those with epilepsy are seizure-free after their first drug.¹³ These drugs, known as anti-epileptic drugs (AEDs), vary. Doctors pick them based on the patient’s age and the kind of seizures they have.¹⁴

Types of Anti-Seizure Drugs

Some common AEDs include sodium valproate, carbamazepine, and others.¹⁴ These drugs help by making the brain’s electrical activity steady. This stops most seizures, but they don’t cure epilepsy. AEDs work for nearly 7 out of 10 people with epilepsy.¹⁴

Managing Medication Levels

Taking the right dose at the right time is crucial. Patients need regular blood tests to check their drug levels.¹³ The way people process these drugs can vary. That’s why adjusting doses may help reach the best seizure control.¹³ But, all drugs can cause side effects. So, it’s important to talk about any worries with a healthcare provider.

Ketogenic Diet for Epilepsy

Some kids with epilepsy don’t get better with just medicines. For them, doctors might suggest a special diet. It’s called the ketogenic diet and it’s high in fats but low in carbs.¹⁵ This diet makes the body create ketones. Ketones are formed when the body uses fat for energy, not carbs. This change can help lower seizures, but we’re still learning about why.¹⁵

What is a Ketogenic Diet?

The ketogenic diet is super strict, with 90% of food from fats.¹⁵ It needs careful thought in planning meals. When kids start this diet, they usually stay in the hospital a few days. This is to start the diet safely and learn how to make the meals right.¹⁵ They may follow this diet for over two years before going back to a normal diet.

How the Ketogenic Diet Works

Doctors think the ketogenic diet helps with seizures by creating ketones. Body starts breaking down fat for energy, not carbs.¹⁵ This is like being in a fasted state, which can stop some seizures.¹⁵ There’s also good news about a similar diet called MAD, which is being used more. It’s not as strict as the classic ketogenic diet.¹⁵

Research shows the ketogenic diet works well with refractory epilepsy in kids and adults. Refractory epilepsy is when seizures don’t stop with usual treatments.¹⁵ More than half the kids who try this diet see a big drop in their seizures.¹⁶ And about 10 to 15 out of 100 children might not have seizures at all.¹⁶ So, this diet is a good choice for some who can’t have surgery.¹⁵

While the ketogenic diet is strict and hard to follow, it needs a lot of watching. It shouldn’t be used if someone has a rare disease called primary Carnitine deficiency.¹⁵ But, many have seen good results with this diet, like more than 70 out of 100 people in some studies.¹⁵

Surgical Treatment for Epilepsy

According to the Third source,¹⁷ some children with epilepsy might benefit from surgery. This is when medicine doesn’t control their seizures well. These surgical procedures are very detailed. They are done by a special team of doctors. The goal of epilepsy surgery can be to remove the part of the brain triggering seizures. Or it might stop the spread of these abnormal signals. This can help control the seizures.¹⁷

During these surgeries, some children have to stay awake. This is so the doctors can check that important brain functions are okay. It helps them not harm parts of the brain that control vital functions. But remember, not everyone with epilepsy is a candidate for surgery. The choice to do surgery is a big decision. It’s made after talking with the child’s healthcare team.¹⁷

Surgical Procedure	Seizure Freedom Rate
Temporal Lobe Resection	60-70%¹⁸
Frontal Lobe Resection	Up to 50%¹⁸
Hemispherectomy/Hemispherotomy	Over 80%¹⁸
Laser Interstitial Thermal Therapy (LITT)	More than 50%¹⁸
Corpus Callosotomy	Over 80%¹⁸

The table shows how likely different epilepsy surgeries are to make patients seizure-free. It’s all from the data the Second source shared.¹⁸

Brain Stimulation Therapies

Brain stimulation therapies offer new hope for those with epilepsy not controlled by meds. Vagus nerve stimulation (VNS) is one option. It’s for kids over 12 with resistant partial seizures.¹⁹

Vagus Nerve Stimulation (VNS)

VNS uses a small device powered by a battery. It’s put in the chest and sends electrical signals to the neck’s vagus nerve.¹⁹ This technique tries to change how the brain acts, aiming to reduce seizures. Although VNS doesn’t completely stop seizures, it can lower how many happen and how bad they are.¹⁹

VNS might cause hoarseness, throat pain, or voice changes. Doctors turn to VNS when other epilepsy treatments don’t work.

Living with Epilepsy

Many people with epilepsy face daily challenges but also find opportunities to stay well.²⁰ It’s hard for their families, too. Families might face additional stress because of the disorder.²⁰ Luckily, those with epilepsy can learn to spot triggers that come before seizures. The Second and Third sources talk about this.²⁰

Seizure Triggers

Key triggers for seizures include stress, not getting enough sleep, using alcohol or drugs, and hormonal changes. Also, certain medicines, rapidly changing lights, and forgetting to take seizure meds can trigger seizures.²¹ Each state has different driving laws for people with medical conditions like epilepsy. The DMV looks at your health info when you apply for a license. So, it’s vital to know and follow the driving rules.²¹

Seizure Diary

Keeping a detailed seizure diary is essential, per the Third source.²¹ This diary should include the time, type, and what was happening before each seizure. Doing this can help pinpoint triggers and signs that could help adjust your treatment.²⁰ Also, getting enough sleep, eating well, and managing stress is crucial for those with epilepsy. With the right care and lifestyle, many can keep their seizures under control.²⁰

Support and Resources

Epilepsy is a serious condition but many groups and resources can help. The Epilepsy Foundation provides materials, groups, and services.²² Online communities also offer support.²³ Joining these helps in dealing with epilepsy.

Epilepsy Organizations

Groups like the AES and CURE help those with epilepsy.²³ The Epilepsy Foundation is another key support.²³ For pregnant women with epilepsy, the Drug Pregnancy Registry checks medicine safety.²³ The REN supports those with rare types.²³ It creates a special research database. The Social Security Disability Help aids in getting support.²³ For changing doctors, there are tips available too.²³

Online Communities

Online, there are many forums and communities for epilepsy.²³ They give information and support.

People with epilepsy sometimes feel down.²² Mental Health Month helps remind us that good mental health is crucial.²² A special $100,000 award from the CDC supports a program on mental health and epilepsy.²² MEW and PACES help with mental health in epilepsy.²² The Epilepsy Foundation runs support groups and offers bereavement services.²²

Conclusion

Epilepsy is a common condition, affecting about 50 million people around the world.⁵ It can show up in anyone and brings a variety of seizure signs. But, with the right care, many can lead full lives.⁵ Ongoing studies aim to make treating epilepsy better. They look into medicines, special diets, surgeries, and therapies that stimulate the brain.⁵

Combine medical help with lifestyle changes, and up to 70% of epileptic people might not have seizures.⁵ Yet, getting the needed treatment is hard for many, especially in poorer countries.⁵ We must make sure everyone with epilepsy gets the support they need. Doing so will help lessen the worldwide impact of this disease.⁵²⁴

Help and groups are out there for those with epilepsy and their loved ones. They offer support for the tough times and help with daily life. By lifting up those with epilepsy and teaching others about it, we can aim for a better future. One where they can live well and succeed.⁵²⁴

FAQ

What is epilepsy?

Epilepsy is a brain disorder. It causes repeated seizures from unusual brain electrical activity.

What causes the abnormal brain activity in epilepsy?

Brain cell damage triggers the electrical storms in epilepsy. This can be due to genetic issues, past brain damage, or unknown reasons.

How prevalent is epilepsy?

Epilepsy affects about 3.4 million Americans; it’s more common than you might think. It’s the fourth most widespread neurological disorder in the U.S.Globally, over 65 million people are living with epilepsy.

What are the different types of seizures?

Seizures fall into two main types. One starts in a specific part of the brain, while the other involves many brain areas. There are many kinds of each, like jerking, staring, or muscle tightness.

What are the symptoms of seizures?

Seizures show various signs, depending on their type. They can include jerking, staring, muscle loss, or stiffening. You may also notice sudden muscle jerks.

How does epilepsy disrupt normal brain function?

Epilepsy stops the brain’s usual electrical patterns. This causes sudden bursts of energy, changing feelings, movements, and awareness during seizures.

How is epilepsy diagnosed?

Doctors use many tests to find epilepsy. This includes brain wave tests, scans, and exams to understand seizure types and rule out other problems.

How is epilepsy treated?

Medication is the main treatment, helping over half of the patients stop seizures. Some might also benefit from a special diet, surgery, or nerve stimulation.

What are some common triggers for seizures?

Seizures might be triggered by stress, lack of sleep, or alcohol. Other triggers are hormonal changes, certain medicines, or flashing lights. It’s crucial to get enough rest, eat well, and manage stress to help control seizures.

What resources are available for people with epilepsy?

There are many resources for epilepsy, like specialized centers and the Epilepsy Foundation. Online support groups and forums also provide help for patients and their families.