Epilepsy: Symptoms and Treatment

Overview

Epilepsy is a central nervous system (neurological) disorder in which a person has unprovoked, recurrent seizures over time. Seizures are episodes of uncontrolled and abnormal firing of brain cells that may cause brief changes in movement, behavior, feeling, or awareness.

The World Health Organization (WHO) estimate that epilepsy affects 65 million people around the world. In the United States, it affects about 3.4 million people, including 3 million adults and 470,000 children. It occurs slightly more in men than in women.

There’s no once-and-for-all cure for epilepsy, but the disorder can be managed with medications and other strategies.

Causes

In about half
the people with the condition, the exact cause of epilepsy is not known. In the
other half, the condition may be traced to various factors, including:

  • Genetic influence

Researchers have
linked some types of epilepsy to specific genes, which may make a person more
sensitive to environmental conditions that trigger seizures.

  • Head trauma

Traumatic brain
injury brought about by a car accident or other traumatic injury can cause
epilepsy.

  • Brain conditions

Brain conditions such as brain tumors, strokes, dementia, transient ischemic attack (TIA), and abnormal blood vessels in the brain, can cause epilepsy.

can cause
epilepsy.

  • Infectious diseases

Infectious
diseases, such as meningitis, AIDS and viral encephalitis, can cause epilepsy.

  • Prenatal injury

Several factors,
such as an infection in the mother, poor nutrition or oxygen deficiencies before
a baby’s birth can damage his or her brain and result in epilepsy or cerebral
palsy.

  • Developmental disorders

Epilepsy can sometimes be associated with developmental disorders, such as autism and neurofibromatosis

Symptoms

There are two types of seizure: partial seizures and general
seizures. Symptoms differ from person to person and according to the type of
seizure.

Focal (partial) seizures

Simple partial seizure:

  • alterations to sense of taste,
    smell, sight, hearing, or touch
  • tingling, dizziness and flashing
    lights
  • involuntary jerking of limbs

Complex partial seizures:

  • changing
    or losing awareness or consciousness
  • staring
    blankly
  • unresponsiveness
  • performing
    repetitive movements

Generalized
seizures

Absence seizures

  • staring
    blankly
  • making
    repetitive movements like lip smacking or eye blinking
  • having
    a short loss of awareness.

Tonic
seizures

  • having
    muscle stiffness.

Atonic seizures

  • losing
    muscle control
  • losing balance and falling down

Clonic seizures

  • making
    repeated, jerky muscle movements of the face, neck, and arms.

Myoclonic seizures

  • twitching
    the arms and legs.

Tonic-clonic seizures

  • stiffening of the body
  • shaking
  • loss of bladder or bowel control
  • biting of the tongue
  • loss of consciousness

Diagnosis

The diagnosis is
based primarily on your symptoms that are described. Usually, the physical exam
and neurological examination are normal between spells. An adult who
experiences a seizure for the first time will be evaluated with a head scan and
blood tests to look for chemical imbalances. Your doctor will order further
tests including:

  • Electroencephalogram (EEG).
  • Computerized tomography (CT) scan.
  • Magnetic resonance imaging (MRI).
  • Functional MRI (fMRI).
  • Positron emission tomography (PET).
  • Single-photon emission
    computerized tomography (SPECT).
  • Neuropsychological tests.

Along with your test results, your
doctor may use a combination of analysis techniques to help pinpoint where in
the brain seizures start:

  • Statistical parametric mapping (SPM).
  • Curry analysis.
  • Magnetoencephalography (MEG).

Treatment

Doctors generally begin by treating epilepsy with medication. If
medications don’t treat the condition, doctors may propose surgery or another
type of treatment.

Medications

Anti-seizure medications, also called anti-epileptic medications, can reduce the number of seizures you have.

Surgery

With epilepsy surgery, the area of the brain that causes seizure
activity can be removed or altered.

Therapies

Apart
from medications and surgery, these potential therapies offer an alternative
for treating epilepsy:

  • Vagus nerve stimulation.
  • Ketogenic diet.
  • Deep brain stimulation

Keywords: epilepsy, seizure.

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