What is Epilepsy?
Epilepsy is a disorder affecting the signals in the brain which causes recurring seizures.
The disorder can be brought on by an injury, illness or abnormal brain development. However, in some cases the cause is simply unknown.
It’s estimated that just over one percent of the US population suffers with epilepsy. Young children and adults over the age of 55 have a higher chance of developing this neurological disorder. (1,2)
Symptoms
Symptoms of epilepsy are different from person to person. What some experience, others may not.
There are two groups of epileptic seizures: generalized and focal. This can be broken down into a further five main types, of which each one presents different symptoms. (3)
It’s also possible for a person to encounter more than one type, although many will only experience one. These include: absence, tonic-clonic, simple focal, complex focal and secondary generalized seizures.
For some a seizure is an occasional thing, yet for others they occur frequently throughout the course of a day. Furthermore, some people don’t even realize they have epilepsy because the seizures are so mild. (4)
Typical symptoms of epileptic seizures include:
Staring Spells
A staring spell is a typical telltale sign of an absence seizure.
If the person is exposed to flashing bright lights or hyperventilation, it could trigger this type of seizure.
It generally last a few seconds and can be described as where the person is seen staring into space. This is due to an abnormal electrical activity in the brain.
During an episode, the person will usually stop his/her activity for a few seconds before continuing as if nothing happened. This symptom typically goes unnoticed for a while before it is diagnosed. (5)
This is a common symptom seen in children and is usually mistaken for misbehavior.
Abnormal Sensations/Hallucinations
Some people may feel abnormal sensations in the body. For example, this could be numbness, tingling or even hallucinations of something that isn’t there, such as ants or spiders running on the skin.
This could also be classed as seeing and hearing something, or smelling and tasting something ‘funny’.
This is a typical symptom of a focal seizure. (6)
Muscle Contractions
Another telltale sign of a seizure is abnormal muscle contractions such as twitching and jerking body parts or bizarre head movements.
If you see a person experiencing abnormal muscle contractions, it’s important not to hold the person down or stop the movements, unless he or she is in danger. (7)
Abdominal Pain
Abdominal pain is somewhat a common symptom seen in epilepsy. Some people have reported feeling stomach pains a few months prior to their diagnosis of epilepsy.
However, there is also a type of epilepsy called abdominal epilepsy (AE), this is a very rare type and not much is known about it. (8)
People with AE will experience discomforts in the abdominal area, mostly stomach pain, which will come and go. These ‘attacks’ of pain can lead to vomiting and diarrhea.
Pale Skin
Prior to a seizure, the body can sometimes sense something is about to happen, therefore it’s not uncommon for the person to become pale, feel sudden sweating or flushing in the skin. Some people may even get a feeling of goosebumps around the body.
This can lead to distorted emotions. The person may feel angry or sad without explanation or sometimes they become scared, believing something terrible is about to happen. (9)
This occurs if the seizure takes place in the part of the brain which controls emotions.
Déjà Vu
It’s common for people suffering a partial seizure to suddenly not recognize familiar things and places momentarily.
But it can also translate into an experience of déjà vu. This is where unfamiliar places and events all of a sudden look familiar, as if they have encountered it before. (10)
Walking and Running
During a partial focal seizure, some people can be seen wandering off or maybe even start to run.
Although it will only last a short moment, it is important not to hold the person back during a seizure, unless he or she is in danger.
Stiff Limbs
Before a seizure is about to occur some people can feel stiffness and tension building up in either arms or legs.
When the seizure subsides the person may still feel a little tension for a while after.
Stages
There are four stages of epilepsy starting from the first seizure to the discontinuation of treatment. (11)
Stage #1
The first stage is acute symptomatic seizures.
These seizures don’t always show epileptic symptoms, but occur when there’s a disturbance to the brain, for example after a stroke or injury. (12)
This could progress further into epilepsy if not treated correctly.
Stage #2
Epilepsy is diagnosed after the first two unprovoked seizures. In this stage the first one occurs.
At this stage the person will show abnormal results in a neurological exam, along with an underlying symptomatic cause. This indicates a greater chance of relapse for a second unprovoked seizure. (13)
However, diagnosis of epilepsy will not be confirmed until a further episode has occurred.
Stage #3
This is the stage in which the person has now experienced two unprovoked seizures within a short period of time. This means they are considered newly diagnosed with epilepsy.
During this stage it is important to diagnose what type of epileptic seizures the person experiences in order to recieve the right treatment. (14)
Stage #4
Anyone who has been seizure free for over two years will proceed to this stage of treatment discontinuation.
However, there are risks of relapse. In adults there’s a 43 to 65 percent chance of seizures recurring, whereas in children it’s a nine to 39 percent chance. (15)
Some cases are fast forwarded to this stage earlier, however the chance of relapse is higher.
Treatment
There isn’t a definite cure for epilepsy, although with the right treatment and certain lifestyle changes seizures can be minimized.
However, in some cases surgery is deemed necessary. This could be because of tumors, damaged blood vessels or bleeding near the brain. In these instances, surgery might stop the seizures. (16)
Medical Treatment
In order to prevent seizures your doctor will prescribe medication suitable for your type.
Different antiepileptic drugs work to reduce episodes and to manage them. (17)
However, not all drugs will work for everyone, therefore it’s important to get checked regularly by your doctor. This makes sure the medicine is working properly and eliminates any untreated side effects.
Antiepileptic drugs can make bones weaker, as well as cause birth defects if taken by a woman who is pregnant. (18)
Ketogenic Diet
This diet is becoming more popular among parents of children with epilepsy. It was used in the past when antiepileptic drugs weren’t so widely available.
A diet which is high-fat but low carbohydrates, with a normal intake of proteins can reduce the chance of seizures. (19)
Surgery
Surgery is needed by around one-third of people with epilepsy because their seizures can’t be controlled with medication. (20)
The need for surgery is deemed necessary when two antiepileptic drugs have failed to manage the seizures.
Surgeries work to either remove the cause of the seizures or in other cases to plant a vagal nerve stimulator (VNS). It’s a device that works similar to a pacemaker in the heart and will help control the number of seizures. (21)
FAQ
What is epilepsy (seizure)? It’s a disorder of the brain which causes seizures. They can range from mild staring spells to severe convulsions and loss of consciousness.
What are the signs of epilepsy (seizure)? The signs depends on what type epileptic seizure is occurring. Typical signs are dazed looks, pale or sweaty skin. Stiffness in the limbs or abnormal muscle contractions and déjà vu.
How do you develop epilepsy (seizure)? Epilepsy can be caused by different things, some people are born with a defect in the brain, other common causes are strokes, brain injuries, infections, brain tumors or other illnesses which can destroy brain tissues. (22)
How are you diagnosed for epilepsy (seizure)? Doctors will normally use an EEG test which examines the person’s brain activity over the course of a week. Blood and lumbar tests can be carried out to rule out other causes. MRI and CT scans will also be used to identify any underlying causes in the brain. (23)
What is the best treatment for epilepsy (seizure)? The best treatment is antiepileptic drug, this can be followed up by the ketogenic diet. However some cases do require surgery.
What are the long term complications of epilepsy (seizure)? Long term complications include permanent brain damage and in some cases sudden unexpected death in epilepsy (SUDEP). This can occur after many seizures. (24)
Is epilepsy (seizure) considered a disability? Yes, for some types of epileptic seizures it is considered a disability, especially after the point of permanent brain damage.
Is there a cure for epilepsy (seizure)? No there’s isn’t a medical cure, although seizures can be prevented after a prolonged period of the right treatment.
Is epilepsy (seizure) life threatening? Yes in cases of SUDEP or if the person is having a severe seizure in a unsafe place it could be fatal.
Summary
We have learned that when it comes to epilepsy (seizure) there are many causes and types of the disorder.
Many episodes are mild ‘spells’ of what can be described as vagueness, most of which goes unnoticed or is easily mistaken for something else.
Although a severe epileptic seizure can be scary for the onlooking person, knowing when to intervene and when to stand back is key.
However, with the right treatment, lifestyle changes and a solid support network, epileptic seizures can be managed. These important factors lay the foundations towards a better quality of life for those with epilepsy.