|What is epilepsy?
Epilepsy is a family of more than 40 neurological conditions that share a
common symptom Ė seizures. It affects about 2.5 million americans and can
result from head injury, infection, fever, brain tumors, or other trauma that
damages the brain.
Normally, brain cells communicate with each other through electrical impulses
that work together to control the bodyís movement and keep the bodyís organs
functioning properly. When thousands to millions of electrical impulses occur at
the same time producing abnormal brain activity, the result can be a seizure.
The part of the brain where the abnormal electrical activity occurs determines
the type of seizure.
There are over thirty types of seizures, some more severe than others. Some
people have seizures that last a short time and cause them to stare off into
space, giving the appearance that the person is simply daydreaming. Others may
experience a more dramatic seizure (tonic-clonic seizure) where the person loses
consciousness and the entire body stiffens and then twitches or jerks
People of all ages, races, and in all walks of life can develop epilepsy. It
affects about one in 100 people. It is not contagious, and it is not a mental
illness. Most forms of epilepsy are not inherited, but it may run in some
While there is, as yet, no cure for epilepsy, todayís treatment options can
control most cases. In fact, many people with epilepsy lead normal lives and
have no symptoms between seizures. The aim of treatment is to stop the seizures.
What causes epilepsy?
There is no single cause of epilepsy, and in 70% of cases, no known cause is
Some of the known causes of epilepsy are:
How is epilepsy diagnosed?
- Injury to the brain before, during, or after birth
- Infections that damage the brain
- Toxic substances that affect the brain
- Injury and lack of oxygen to the brain
- Disturbance in blood circulation to the brain (stroke and other vascular
- Metabolism or nutrition imbalance
- Tumors of the brain
- Hereditary disease affecting the brain
- High fever
- Other degenerative diseases
Because there is no test to diagnose epilepsy, a doctor must rely mainly on
interpreting the patientís medical and family history. Thus, it is important
that the doctor have experience with and treat people with neurological
disorders such as a neurologist. When the patient describes what he or she
experience, and someone who witnessed the seizures describes what he saw, the
doctor can often determine what kind of seizure the patient experience and treat
The doctor asks about the patientís past medical history, the motherís
pregnancy, and the familyís medical history. The doctor will do general
physical and neurological examinations to look for the underlying cause of the
The doctor usually orders an electroencephalogram (EEG) test, a painless
recording of the patientís brain waves. The EEG, however, may appear normal
even if the patient has epilepsy. Another painless test- a magnetic resonance
imaging study or MRI- may reveal scar tissue or a structural abnormality within
the brain, helping the doctor to make a diagnosis of epilepsy.
||What are the symptoms?
The doctor diagnoses epilepsy after a person has had multiple seizures. The
frequency and type of seizure varies from person to person. Some people have
more than one type.
The medical community classifies epileptic seizures into two major
categories: partial and generalized. The form a seizure takes depends on the
part of the brain in which it occurs and on how widely and rapidly it fans out
from its point of origin.
If the abnormal electrical activity involves one area of the brain, the
seizure is partial. The person may not lose consciousness, but can experience a
range of symptoms: sudden jerky movements of one part of the body, such as an
arm or leg; sudden fear; facial movements; disturbances or hallucinations of
vision, hearing, or smell; nausea, vomiting, or stomach discomfort.
Some types of partial seizures (called complex partial seizures) may cause
the person to have a change of consciousness. They may be dazed and confused,
unaware of where they are or what they are doing. They may wander around
randomly, mumble, and behave in unusual ways. They may exhibit chewing or
repetitive arm and hand movement. Moreover, people with this type of seizure
will not remember what they have experienced.
When the entire brain is involved, the seizure is generalized. Like partial
seizures, there are many different symptoms, body movements, and activities.
Some people stare off into space, while others may have a full convulsion with
the complete loss of consciousness and jerking movements of limbs (tonic-clonic
Just before having seizures, some people experience an aura, which is a
sensation or warning of a coming seizure. Some people feel a sense of tension or
anxiety, may hear a musical sound, sense an odor or taste, or experience some
other change in sensation. Often this aura gives the person time to get to a
safe place to avoid injury.
Most major epileptic seizures (generalized or tonic-clonic) last only a
minute or two and demand little of the bystander. All that is necessary is to
let the seizure run its course and to ensure that the person is in no physical
danger and can breathe.
However, a person who experiences repeated seizures and does not recover
consciousness between attacks should get immediate medical attention. This type
of repeated seizure is called status epilepticus. This is life threatening, and
could also cause brain damage.
Progress through research
Epilepsy research has focused on finding the cause of epilepsy and on
understanding ways to accurately diagnose and treat it. Researchers continue to
study the chemical and electrical changes that occur within the brain cells.
Clinical trails of new drugs are constantly underway, and new surgical
procedures are being developed.
Among the new drugs being introduced are some that inhibit or change the
brain cell activity that causes seizures. These are new strategies for seizure
control and mean that doctors will be able to offer new choices to prevent
previously difficult to control seizures.
In addition to developing new drugs, researchers are taking a fresh look at
some of the ideas that have been part of epilepsy treatment for many years. It
is important that patients talk with their neurologist if they wish to persue
these lines of treatment. For example, the ketogenic diet, high in fat and low
in carbohydrates and protein, creates a condition in the body known as
"ketosis", that has been helpful in controlling seizures, particularly
in children. Researchers are looking at the exact mechanism of action of the
ketogenic diet to shed new light on the biochemical mechanisms of epilepsy.
Surgeons have found that implanting a small device in the body that gives off
electronic signals to the brain can stop seizures. This treatment has been
especially promising for those with uncontrollable epilepsy.
Please contact the AAN Education and Research Foundation to contribute to the
fight against epilepsy and other neurological disorders. Only through continued
research can we hope for more treatments and a cure. Call (612) 695-2712