Patients & Caregivers
As a patient with epilepsy or a caregiver of someone who has epilepsy, you may have questions. The following information should help you gain a better understanding of what epilepsy is and our goals in treatment.
What is Epilepsy?
Epilepsy is a condition of recurrent unprovoked seizures. A seizure is an abnormal, uncontrolled electrical discharge in the brain. While an isolated seizure may occur from extreme stresses such as high fever or low blood sugar, epilepsy means a seizure disorder where there is a disturbance in the electrical system of the brain leading to seizures in the absence of these extreme stresses.
The symptoms experienced during a seizure may be very different for different individuals. One type of seizure might result in loss of consciousness, falling to the ground, and whole body shaking. Another might involve simply twitching of the fingers of one hand, with all other functions preserved. Seizures can be divided most simply into partial onset or generalized onset seizures
Partial onset seizures
These are seizures that begin in a particular focus in the brain. This may be a known focus, such as a brain tumor, stroke, or area of scarring from head injury, or there may be no known cause identified even with the most detailed brain imaging techniques such as MRI scans.
If only a small part of the brain is involved by the seizure, and the person does not lose awareness of what is going on around them, then this is called a simple partial seizure. Simple because awareness or consciousness is not affected, and partial because it is partial in onset.
If a larger brain region is involved by the seizure, and especially if both halves of the brain are involved and consciousness or awareness is affected, the seizure is then called a complex partial seizure—complex because consciousness is impaired to some extent.
Sometimes the seizure discharge may spread to involve the whole brain, and cause a secondarily generalized tonic clonic seizure. These seizures used to be called "grand mal" seizures.
Generalized Seizures
These are seizures that essentially begin in the whole brain (or at least both halves of the brain) at once. Often these seizures begin in childhood and may be the result of an inherited (genetic) tendency to have seizures. Generalized seizures can be of several types. These include generalized tonic clonic seizures, formerly called "grand mal" seizures. The difference from a secondarily generalized tonic clonic seizure is that there is no distinct localized seizure focus here. Other types of generalized seizures include absence seizures, which are characterized by brief loss of awareness, usually lasting seconds; and tonic and atonic seizures, where the body suddenly stiffens or goes limp, often resulting in falls and injuries.
Importance of diagnosing seizure types
Your doctor will spend time talking with you about your seizures to try to determine the seizure type. This is important because certain types of seizures may respond best to particular medications or treatments. This information also may be important in searching for a cause of the seizures and directing other evaluation.
The goal of the OHSU Epilepsy Team is to gain an understanding of your seizure types and to find the best form of treatment for you. Please feel free to call our office at 503 494-5682 with any questions you may have. We would be more than happy to help you find the appropriate resources for your care. If you are interested in becoming a patient with our clinic, please contact our scheduling office at 503 418-4901 for more information.
