Epilepsy is a medical condition where abnormal electrical brain activity causes symptoms such as seizures, loss of awareness, and/or unusual behavior or sensations. Seizures can affect each person differently. Some simple stare, whereas others might twitch their limbs or shake. Epilepsy might eventually go away, or it might require lifelong management.
Around 3.4 million adults and 470,000 children have epilepsy in the United States. Here are some other trends:
Age: Epilepsy is diagnosed most often before age 20 and after age 65.
Race: Epilepsy is more common among Hispanic patients than non-Hispanics. Black patients have a higher lifetime prevalence, but active epilepsy is more common among white patients.
In approximately half of epilepsy cases, there is no known cause. The other half of diagnoses might be traced back to risk factors such as:
Family history of epilepsy
Head trauma
Brain conditions (including tumors and strokes)
Dementia
Infection diseases (including meningitis, AIDS, and viral encephalitis)
Brain damage to a fetus
Developmental disorders (including autism and neurofibromatosis)
Overall symptoms of epilepsy can include:
Temporary confusion
Staring
Uncontrollable shaking or jerking of the arms and legs
Loss of consciousness
Fear, anxiety, or a feeling of deja vu
There are two main classes of seizures a person with epilepsy might get: focal seizures and generalized seizures.
Focal seizures happen because of abnormal activity “focused” in just one part of the brain. They can be further broken down into:
Focal seizures without loss of consciousness: This type of focal seizure may still change how you feel emotionally, affect your fives senses, cause involuntary jerking of your body, and tingling, dizziness, or flashing lights.
Focal seizures with impaired consciousness: This type of focal seizure may cause you to stare into space, lose some of your awareness, and cause you to do repetitive movements such as swallowing, rubbing your hands, chewing, or walking in circles.
The second class of seizure, generalized seizures, affects all areas of the brain. They can be further broken down into six types:
Absence seizures: These most commonly affect children and cause them to stare in space or repeat body movements such as smacking their lips or blinking.
Tonic seizures: This type stiffens the muscles in your body, usually your back, arms, and legs—which may cause you to fall down.
Atonic seizures: This results in a complete loss of muscle control, which can also lead to a fall.
Clonic seizures: This usually causes repeated, jerking movements of the muscles in your neck, face, and arms.
Myoclonic seizures: These cause sudden, brief jerks of your arms and legs.
Tonic-clonic seizures: This type can cause a loss of consciousness, body stiffening, shaking, loss of bladder control, and tongue biting.
Primary Care Physician: Your general doctor might be able to diagnose and treat epilepsy.
Neurologist: Neurologists are doctors that specialize in brain disorders, including epilepsy. Neurologists with specific training for epilepsy are called epileptologists.
Epilepsy is usually diagnosed through a neurological exam, which can include tests focused on your behavior, motor abilities, and mental function. Blood tests may also be performed to check for signs of infections, genetic conditions, or other underlying conditions that may cause seizures.
There are many other tests a doctor might order, including electroencephalogram (EEG), CT scan, MRI, functional MRI, and others. EEGs measure the electrical activity in the brain and CTs and MRIs create pictures of the brain.
Seizures can often be managed and/or prevented with anti-seizure medications.
As pharmacists, we often get asked if epilepsy requires a life-time treatment of anti-seizure medication. The answer is that it really depends on your seizures. If you don't have any seizures for several years, your doctor might talk with you about stopping your medicine. But don't ever stop your medicine on your own. To lower your chances of having more seizures, you can take the following steps:
Take your medicine exactly as directed
Get enough sleep! Not getting enough sleep raises your chances of having a seizure.
Avoid drinking alcohol or using drugs
Make sure to talk with your doctor before you plan on getting pregnant. They might change your anti-seizure medicine or prescribe a vitamin called folic acid. But again, don't ever stop your medicine on your own. Regarding driving with epilepsy, each state and country has its own rules. Before you can drive again, you will probably need to be seizure-free for a certain amount of time. You might also need to get your doctor's permission.
Lastly, you should wear a medical bracelet to let others know about your epilepsy. And, make sure to let family members and friends know how to help you if you have a seizure. They can position you so that you will not hurt yourself, but they should not put anything in your mouth. They should time your seizure and call for an ambulance (in the US and Canada, dial 9-1-1) if it lasts longer than 5 minutes. A seizure is also considered a medical emergency if you have 2 or more seizures without waking up in between. Your doctor will make a plan with you that tells you when to call them. In general though, call your doctor or nurse if you have more seizures than usual, or your seizures last longer than usual.
Make sure you get enough sleep, as exhaustion can trigger seizures. Consistent exercise and hydration can also help keep your body strong and healthy. Lastly, make sure to wear a medical alert bracelet in the case of a seizure that requires emergency medical attention.
