Epilepsy is a condition that produces seizures affecting a variety of mental and physical functions. These seizures happen when clusters of nerve cells in the brain signal abnormally which may briefly alter a person's movements, actions or even consciousness. According to the Centers for Disease Control and Prevention, epilepsy affects 2.2 million Americans. According to the Epilepsy Foundation, Epilepsy is the fourth most common neurological disorder in the U.S. after migraine, stroke, and Alzheimer's disease. Its prevalence is greater than autism spectrum disorder, cerebral palsy, multiple sclerosis and Parkinson's disease combined.
With the exception of very young children and the elderly, the cause of the abnormal brain function is usually not identifiable. When seizures occur, a physician will try to find an underlying cause however there is only a clear cause for epilepsy in a minority of cases. Typically the known causes of seizures involve some type of injury to the brain. Although there is growing knowledge of Epilepsy and its causes, still approximately 70% of cases are of an unknown cause.
According to the Epilepsy Foundation, the following have been identified as potential causes:
- Brain malformations
- Lack of oxygen during, or before delivery, or at birth.
- Low levels of blood sugar, blood calcium, blood magnesium or other electrolyte disturbances
- Inborn errors of metabolism (chemical disorders)
- Intracranial hemorrhage (bleeding in the brain)
- Maternal drug use
- Infants and Children
- Fever (febrile seizures)
- Brain tumor (rarely)
- Brain Malformation
Children and Adults
- Congenital conditions (Down syndrome; Angelman's syndrome; tuberous sclerosis and neurofibromatosis)
- Genetic factors (Primary seizure disorders)
- Progressive brain disease (rare)
- Head trauma
- Alzheimer's disease
- Head trauma
The main symptom or signs of Epilepsy are seizures. The seizures vary from person to person and they could be subtle or they could be drastic. An affected person could simply stare at nothing for a few seconds, they could lose consciousness, could exhibit strange behavior, like speaking nonsense, or could convulse violently. Although they can vary, symptoms can usually be associated with the type of seizure a person has. Seizure types can be identified by what type of body functions are affected and the extent of the seizure.
Types of seizures may include:
Because there are various conditions that can cause seizures, the diagnosis of epilepsy is based much on what is relayed to the doctor by the patient. However, because a person having a seizure sometimes cannot remember or account for the details of what happened it is also good to have the seizures witnessed so that the person witnessing can document the symptoms associated with the seizure and provide the information to the physician.
Your physician will want to also capture a complete medical history and as much information as possible including family history of epilepsy or other neurological conditions. Your physician will also want to get detailed information about when the seizures started, what type of seizures you are experiencing and what you were doing immediately preceding the seizure.
There are also other diagnostic tests that can be done that your doctor will order such as an EEG or CT Scan. Your physician or expert at SCCNS will explain all diagnostic procedures during your initial consultation.
The treatment of Epilepsy will depend on what type of seizures you have, the type of Epilepsy and the severity as treatments for one type of seizure may have no effect on other kinds. There are different variables in the best treatment course such as patients age, overall health, lifestyle, etc. Epilepsy is usually treated with medications as the first approach. These medications do not cure Epilepsy but they can help prevent the seizures.
Epilepsy can be treated by your primary care physician however usually it is treated by a neurologist or a neurosurgeon depending on the severity. Accurate differentiation between generalized and partial seizures is important in determining the appropriate treatment.
If medications do not help control seizures, the implantation of a vagus nerve stimulator or Deep Brain Stimulation may be considered as an option. This option should be performed by and experience neurosurgeon. SCCNS has an expert on staff able to assist you if this is found to be the best option. In addition to vagus nerve stimulation, a neurosurgical operation for people with focal seizures that do not respond to conservative treatment or medication can be palliative and can reduce the frequency or severity of seizures; or, in some patients and operation can be curative. These treatment options should be discussed with your physician.
All adolescent and adult patients are evaluated on a case by case basis. Although we generally we do not see pediatric epileptic patients, if needed we can help you find a pediatric specialist in your area.