Understanding Epilepsy

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Epilepsy is a neurological condition that causes disturbances in electrical signaling in the brain, which in turn causes seizures and sometimes loss of consciousness. Not all seizures are epilepsy. Epilepsy is diagnosed after a person has had two or more seizures that are not caused by another known medical condition or health issue, such as low blood sugar.

The symptoms of an epileptic seizure vary widely. A person may lose consciousness, fall to the ground, and shake all over. Others may have mild symptoms — moments of staring blankly into space or twitches in the fingers of one hand.

People can develop epilepsy from a brain injury, a stroke, a tumor or an infection. However, for many people with epilepsy, the cause is unknown.

Even people with mild epilepsy need treatment. There is substantial risk of injury from having a seizure while doing daily activities. A high percentage of epilepsy patients are able to find control for their seizures with medication.

Epilepsy treatment options

The goal of treatment is to allow people with epilepsy to continue normal activities by stopping their seizures entirely, or significantly decreasing their frequency. First, we use our expertise and a range of tools and technology to diagnose the cause of your seizures. Treatment options then depend on many factors, including type of seizures, overall health and age of the patient.

Those options include medication, which can be effective for many types of epilepsy and seizures. If medication isn’t effective, patients might opt for one of a range of surgical options to help stop or limit their seizures.

Epilepsy Frequently Asked Questions

Q: How common is epilepsy?

A: Between one half of one percent and one percent of people on earth live with active seizures at any one time.

One in 26 people will develop epilepsy at some point in their lifetime.

Q: What is the cause of epilepsy?

A: Epilepsy can be caused by different conditions that affect a person's brain. Examples include stroke, a brain injury or a brain infection. But in two out of three cases, the cause of epilepsy is unknown.

Q: If I have epilepsy, will my children also?

A: Most children of people with epilepsy don’t develop seizures or epilepsy. It’s possible that your children may be at a slightly higher risk than normal. But the chances that they will have epilepsy are still very low.

Q: What are the types of seizures?

A: Seizures are divided into two broad categories: generalized and partial.

Generalized seizures affect the entire brain from the beginning of the seizure. One example is a tonic-clonic seizure — once called a “grand mal” seizure — in which the entire body stiffens and jerks and a person loses consciousness. Another example is an absence seizure — once called a “petit mal” seizure — in which a person loses awareness and has a blank stare. A third example is atonic seizure, which causes the body to lose muscle tone with no warning and often causes the person to fall.

Partial seizures affect only a part of the brain. They include simple partial seizures, in which a person may have jerking movements and abnormal sensations, such as extreme emotions or changes in taste, and complex partial seizures, in which a person can lose awareness, or be confused.

Q: How long do most seizures last?

A: Most tonic-clonic seizures last less than three minutes, with many of them lasting 60 to 90 seconds. Absence seizures usually last about 10 seconds.

Q: What is status epilepticus?

A: When a seizure lasts longer than five minutes, or when there is more than one seizure within five minutes with the person not returning to a normal level of consciousness, it is called status epilepticus. Such long seizures can lead to permanent brain damage or death and often can be stopped only with medication. That’s why it’s important to get immediate medical help for any seizure lasting longer than five minutes.

Q: Why is it necessary to treat epilepsy?

It is important to treat seizures because uncontrolled seizures can cause severe injuries and death. There can be some effect on the brain from repeated seizures. But much of the danger comes from the secondary effects of a seizure. People’s seizures can cause them to fall, leading to broken bones and head injuries. And people who have seizures should not swim or drive, because of the dangers of having a seizure while doing either.

Q: What are the treatments for epilepsy?

The most common, and often successful, treatment for epilepsy is medication. Your doctor will recommend a medication based on the type of seizures you have, along with your age and gender, possible side effects and other factors. You and your treatment team will work together to adjust the medication to be most helpful and minimize side effects. If the first medication doesn’t work, you may try others.

If medication doesn’t help, you might consider surgery or other minimally invasive procedures and devices that can help. Dietary therapy can also help in many cases.

Q: How often does medicine work for seizures?

A: Medicine can prevent or significantly reduce seizures in about two-thirds of people with epilepsy.

Q: Can diet help with epilepsy therapy?

Research has shown that special diets can help reduce seizures in some children and adults with epilepsy. Two of the most common dietary plans recommended for some people with epilepsy are a ketogenic diet — high in fat and low in carbohydrates — and a modified Adkins diet, which is similar to, but less restrictive than, a ketogenic diet.

Ketogenic diet:

A ketogenic diet is more often recommended for children, especially those whose seizures have not responded to several different seizure medicines. The diet provides three to four grams of fat for every one gram of carbohydrate and protein. Common foods that provide the fat for a ketogenic diet are butter, heavy whipping cream, mayonnaise and oils like canola or olive oil.

A ketogenic diet has reduced or prevented seizures in many children whose seizures could not be controlled by medications. It also has proven effective for some adults with epilepsy.

Modified Atkins diet:

The modified Atkins diet is also high in fat and low in carbohydrates but is less restrictive than the ketogenic diet. Its use for epilepsy patients goes back to the early 2000s.

The diet is modified from the traditional Atkins diet because a low carbohydrate limit is maintained indefinitely rather than gradually increased after an initiation period, and high-fat foods are mandatory rather than encouraged in the Adkins diet. The diet is most often used for adults with epilepsy. Studies have shown that the diet substantially reduced seizures in almost half of the adults who have tried it.

Q: Where can I find more info about epilepsy?