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Epilepsy: Symptoms, Causes & Treatment

Epilepsy
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What is Epilepsy?

Epilepsy is a central nervous system disorder caused by abnormal brain activity. Recurring seizures are the primary symptom of this condition.

People of any age can develop epilepsy, although it usually surfaces before age 10 or after age 55. People are more likely to have it if a family member has it. Estimates show that 70 million people worldwide have epilepsy (x).

Epilepsy has been misunderstood throughout history. The word “seizure” comes from the Greek word, meaning “to hold or seize,” because the gods were “seizing” a person and causing them to have a convulsion (x). In the past, epilepsy was also considered a mental disorder. Fortunately, though, these beliefs have changed. Although epilepsy can occur in individuals with mental illness, most epilepsy patients have no psychological or cognitive problems (x).

Symptoms of Epilepsy

Recurring seizures, which are at least 24 hours apart, are the primary symptom of epilepsy. Seizures are caused by excessive, uncontrolled electrical brain activity and can look different depending on the brain process that is affected (x, x). Signs of seizures may include:

  • A staring “spell”
  • Confusion
  • Uncontrolled, jerky movements of legs and arms
  • Loss of awareness or consciousness

Based on the specific nature of the brain activity, doctors classify seizures into two different categories — focal and generalized.

Focal Onset Seizures

These begin in a singular area of the brain and show limited symptoms. During a focal onset seizure, one may have some awareness of what is happening or confusion.

Generalized Seizures

These types of seizures involve the entire brain and a total loss of awareness or consciousness. This condition may include signs such as stiffening and jerking of arms and legs, biting of the tongue, incontinence and an absent look similar to daydreaming.

What to Do When Someone Has a Seizure

Seizures are relatively common; about one out of ten people may have a seizure sometime in their life. It’s likely for anyone to encounter someone having a seizure, and it’s beneficial to know how to help. Seizures typically last only a few minutes and do not usually require emergency medical help unless the individual has trouble breathing, waking up or if they have never had one before (x).

When someone is having a seizure, it’s important to:

  • Stay with the person until the seizure ends and he/she is fully awake
  • Once the person is alert, calmly explain what has just happened
  • Comfort and calm the person, speaking in simple terms

During a generalized tonic-clonic seizure, the person is unaware of what is happening and may exhibit uncontrolled, jerky movements of the arms and legs. If a person is having this type of seizure, help ease the person to the floor to prevent a fall. Turn the person gently to one side and clear the area of anything hard or sharp. Place something soft under the head and remove eyeglasses and loosen ties that may restrict breathing. If the seizure lasts longer than five minutes, call 911 immediately. Do not try to stop the person’s movements and do not offer food or water until the seizure comes to an end.

Juvenile Epilepsy

It can be difficult to recognize signs of epilepsy in infants and children. Seizures may be short in length and mistaken for daydreaming and other normal behaviors. Seizures can occur when a child has a fever and this can be unrelated to epilepsy. After a seizure, the brain returns to normal, seemingly as if nothing happened. However, recurrent and untreated seizures can be dangerous and interfere with normal development. It’s important for parents and caregivers to know the following signs of epilepsy, so a proper diagnosis can be made (x):

  • Sudden falls or stumbling
  • Unusual clumsiness
  • Mumbling and no response
  • Sudden, repeated anger or fear
  • Memory gaps and dazed behavior
  • Repeated blinking or head nodding
  • Sudden stomach pain followed by drowsiness and confusion
  • Groups of repeated jerky movement by babies who are sitting
  • Groups of grabbing movements with both arms in babies lying on their backs

If you notice any of these signs happening repeatedly, tell your doctor. You can also consult a neurologist, who specializes in conditions like epilepsy (x).

Epilepsy Symptoms

Causes of Epilepsy

There are various causes of epilepsy. However, in about half of diagnosed cases, the cause cannot be determined. Although the following list of conditions can be connected with epilepsy, having these conditions doesn’t mean an individual will actually get epilepsy (x).

Some causes of epilepsy include:

  • Prenatal injury
  • Brain malformation
  • Genetic factors
  • Significant head trauma
  • Stroke
  • Brain tumor
  • Alzheimer’s
  • Other conditions that affect brain function

Diagnosing Epilepsy

Having one seizure doesn’t mean an individual has epilepsy (x). Ten percent of people have a seizure in their lifetime and do not develop epilepsy. These isolated seizures can be caused by conditions completely unrelated, such as:

  • A high temperature (usually in childhood)
  • Poisoning
  • Alcohol consumption
  • Low blood sugar

Epilepsy is often diagnosed when the individual has had at least two seizures, there is a period of at least 24 hours between seizures or there is nothing clear that explains the seizure activity.

The individual’s medical history may give information for the diagnosis. It’s helpful to visit a doctor with someone who was there at the time to explain what happened during the seizures. To monitor brain activity and make a correct diagnosis, the doctor may:

  • Give a physical and neurological exam
  • Take a blood sample
  • Take a sample of cerebrospinal fluid from the lower back region
  • Complete a CAT scan, MRI or EEG test

Treatment for Epilepsy

There is also no known way at this time to prevent epilepsy. Treatment depends on the type and progression of the condition, and the course of treatment is usually managed by a neurologist.

People with epilepsy can control seizures by taking medications or having surgery. Some people adopt a special diet or take natural supplements to treat symptoms.

Medication

Epilepsy treatment usually begins with anti-epileptic drugs, or AEDs. Of course, dosage can change depending on its effectiveness. If one doesn’t work, another medication from another group of drugs may be tried.

With treatment, about 60 percent of people with epilepsy can become free of seizures. If seizures go away, a doctor may wean someone off medication altogether, though this can be risky for various reasons.

Surgery

If medication isn’t successful, doctors may recommend a surgical procedure, such as:

  • Brain surgery: This is considered when someone has partial seizures and it’s obvious which part of the brain is affected. Then this portion of the brain can be surgically removed if possible.
  • Vagus nerve stimulation: This is done with a device similar to a pacemaker. It’s implanted in the chest, where it emits electric signals. Connected to the vagus nerve in the neck, it’s purpose is to prevent overactive nerve impulses.

Diet for Epilepsy

Ketogenic Diet

The ketogenic (keto) diet was first described by a Michigan pediatrician in the 1920s. It is a high-fat, low carbohydrate diet that helps to control seizures in some epilepsy patients. This diet is used in treating some patients that are taking many epileptic drugs and those with specific types of epilepsy, such as De Vivo disease. Health professionals have been reluctant to endorse the diet, and its true effectiveness has remained clinically unstudied (x, x).

Atkins Diet

The Atkins diet uses large amounts of protein to induce a state of fat-burning “ketosis,” which may control some types of seizures.

Calorie Restricted Diet

It’s becoming clear to researchers that there are many health benefits of short-term fasting. In fact, restricting calories with intermittent fasting is having positive effects on individuals with epilepsy (x).

Herbal Medicine for Epilepsy

Though Western medicine has not embraced herbal medicine for treating epilepsy, it has been used in clinical treatments worldwide. Herbal treatments for epilepsy are used in China, Iran, Africa, Europe and in some parts of the United States (x). Herbs used to treat epilepsy include:

Acupuncture for Epilepsy

Acupuncture is a common treatment for seizures. Studies conducted in China and Norway have uncovered some promising signs for acupuncture as a seizure treatment. However, some scientists are still exploring whether acupuncture is a reliable treatment for epilepsy (x).

Marijuana for Epilepsy

Cannabis sativa, or medical marijuana, has been used to treat convulsions for generations. However, it’s now starting to attract attention from researchers and people whose epilepsy cannot be controlled by drugs. CBD is the part of the plant that shows promise in treating seizures. In one child’s case, using a CBD-rich strain of cannabis reduced seizures from 300 a week down to three seizures per month. Studies are ongoing and researchers are still reluctant to recommend cannabis in epilepsy treatment (x).

Natural Supplements for Epilepsy

  • Resveratrol is being studied for easing symptoms of epilepsy (x)
  • 5 HTP, a precursor to serotonin, may reduce the severity of seizures (x)
  • Vitamin E shows promise in reducing seizure frequency and oxidative stress in patients with epilepsy (x)
  • Acetyl L-Carnitine is being studied as a potential treatment for seizures (x, x)

Living with Epilepsy

Living with epilepsy is about living with seizures, but there’s more to consider. Besides seizures, patients may struggle with other related health conditions and epilepsy-related constraints. This impacts an individual’s quality of life, especially if epilepsy is resistant to treatment. Challenges in school and employment, as well as independent living and driving, are some issues that those with epilepsy often have to live with (x).

Migraines and Epilepsy

Migraines and seizures are related, and their symptoms can cause a misdiagnosis. Migraine headaches are more common in people with epilepsy than in the general population (x).

Memory Loss and Epilepsy

Some types of epileptic seizures may affect memory — before, during or after the seizure. The greater the incidence of seizure, the greater probability for some measure of memory loss. The likelihood of memory loss depends on which area of the brain is experiencing the abnormal activity (x, x).

Sleep and Epilepsy

Seizures can disrupt sleep, increase nighttime wakefulness, and reduce the quality of one’s sleep (x).

The Bottom Line

Epilepsy is a neurological condition that occurs as a result of excessive and abnormal brain impulses. Epilepsy’s primary symptom is a series of recurring seizures. The seizures can exhibit different characteristics, depending on the area of the brain that is affected. The cause behind epilepsy can be brain injury and other factors, but some causes are unknown. There are side effects that patients deal with besides seizures, including social factors and issues about living independently. Drugs and surgery are two primary ways that doctors use in reducing seizures. Some patients find relief by following a recommended diet change, or by taking natural supplements and remedies. Patients, both young and old, are still waiting for a cure for epilepsy.

About the author

Ryan Quigley

Graduate of Longwood University in Virginia. Part-time sports journalist covering the Vegas Golden Knights.


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