Epilepsy is not a disease. Epilepsy is a disorder of the brain. The brain controls all of our functions by sending electrical signals through our nerves to control our body’s operation. When there is a misfire of a large amount of electrical energy that is suddenly and unusually discharged into the brain, it is known as a seizure.When a person has two or more seizures with unknown causes, they are said to have epilepsy. Because seizures are a symptom of epilepsy, the condition is also often referred to as a seizure disorder.
A seizure is temporary, ending when the electrical signals stop misfiring. During a seizure, depending on what part and how much of the brain is affected, a seizure can alter a person’s awareness, movements and feelings. When the seizure is over, brain function returns to normal. Seizures can last anywhere from a few seconds to a few minutes. A person can’t control their behavior during a seizure; often a person doesn’t know they are having one. Recovery time varies following a seizure-some people recovery quickly and others have lingering headaches, muscle aches and fatigue after a seizure.
There are two large groups of seizures-partial seizures affect only part of the brain, and generalized seizures affect the whole brain. What happens during a seizure depends on what part of the brain is being affected by the bursts of electrical energy. More information on types of seizures.
Anyone at any age can develop epilepsy. Epilepsy affects people of all ages, races and ethnic backgrounds. The condition can develop at any time of life, however, it is most likely to begin in early childhood or old age. Epilepsy is one of the most common neurological disorders in children. More than 2% of the today’s population is affected by epilepsy–this adds up to more than 3 million Americans living with epilepsy. Epilepsy is the 3rd most common neurological disorder, only behind Alzheimer’s disease and stroke. It is equal in prevalence to Cerebral Palsy, Multiple Sclerosis and Parkinson’s disease combined.
It is important to remember that epilepsy is not contagious and it does not cause mental illness. It is what you have, not what you are. Most people with epilepsy have normal intelligence and some have superior intelligence. Epilepsy is a medical disorder that only affects the person during the few moments when they are having a seizure. People who have epilepsy are just like everybody else–some short, some tall; some shy, some outgoing; some athletic, some not so good at sports; and so on. Everyone has different strengths and weaknesses. Epilepsy is only one part of a person’s life, it should not stand in the way of achievement or success or living life like everyone else!
In more than 7 out of every 10 cases of epilepsy, no exact cause can be found. Some of the known causes include: head injuries, high fever, brain tumors, genetic factors, poisoning, congenital defects or a serious illness that affects the brain (ex: meningitis). Seizures in older people may also be caused by: heart disease, stroke, Alzheimer’s, circulatory problems, diseases affecting the brain, brain tumors or scarring from brain surgery.
How is epilepsy treated?
The treatment options for epilepsy include: Daily medication to prevent seizures called Antiepileptic drugs (AEDs), surgery, ketogenic diet and vagus nerve stimulation.
AEDs treat 70% of cases of epilepsy successfully, but a complication of these AEDs is the common occurrences of side effects. The most common side effects include drowsiness, irritability, nausea, rash and clumsiness. The optimal goal of treatment is to stop seizures with a minimal amount of side effects and today, newer and more effective medications are becoming available in the fight to control epilepsy.
Surgery may be considered after the failure of AEDs. The surgery involves removing a small portion of the brain where seizures typically begin. Surgery is used only in cases in which either the seizures or the amount of medication to control them would disable the patient. Surgical procedures include focal resection, temporal lobectomy, frontal topectomy, lesionectomy, hemispherectomy and corpus callosotomy. Unfortunately, there is no guarantee of success with surgery–seizure free rates vary postsurgically. Much testing must be done before surgery is performed (EEG monitoring, CAT scanning, MRI, PET scan and neuropsychological testing.)
The Ketogenic Diet is high in fat and low in carbohydrates with restricted calories. The diet produces a chemical change in the body called ketosis, which makes your body burn fat for energy instead of glucose–this condition prevents or reduces seizures in some children. The strict diet must be monitored by a physician and a dietitian, and compliance may be a problem. All food must be weighed for every meal and the diet must be followed exactly or it does not work. There are also side effects with this diet including kidney stones, weight loss and blood abnormalities.
Vagus Nerve Stimulation is where a battery, about the size of a silver dollar, is implanted in the upper-left chest (like a pacemaker) and then connected to the vagus nerve in the neck. The battery sends regular small bursts of electrical energy to the brain. These bursts are intended to prevent seizures or to stop them if they start. During a seizure, a magnet can be passed over the battery to give extra stimulation to try to shorten the seizure. Side effects may include hoarseness, coughing and shortness of breath (these occur during stimulation only). This treatment is approved for adults and children over 12 with partial seizures who are resistant to AEDs.
Is there a way to prevent epilepsy?
One day, research may be able to find ways to identify people who are at risk for developing epilepsy and to prevent it before it begins, but for now, the only way of preventing epilepsy is by reducing the risks of things that may damage the brain. This includes vaccines against certain diseases, wearing protective head gear when applicable and using seat belts and child safety seats in automobiles.