Epilepsy is a brain disorder that is marked by repeated seizures over time. Seizures are episodes of uncontrolled and abnormal firing of brain cells that may cause changes in attention or behavior.
Seizures are a symptom of epilepsy, however, they can also be caused by conditions other than epilepsy. A single seizure that does not happen again is not epilepsy.
The type of seizure depends on the part of the brain that is affected. Your doctor can tell you more about the specific type of seizure you may have:
- Absence (petit mal) seizure (staring spells)
- Generalized (grand mal) seizure (involves entire body, including aura, rigid muscles and loss of alertness)
- Partial (focal) seizure (can involve any of the symptoms described above, depending on where in the brain the seizure starts)
Epileptic seizures may occur rarely or every day.
Epilepsy symptoms can also include mood changes, intense feelings of fear or déjà vu, fatigue, jerking or twitching of arms and legs, aura, and sensitivity to flashing lights.
Many people with epilepsy have no symptoms between seizures and lead normal lives. Some people have no symptoms for years and may be weaned off medications.
Causes of Epilepsy
Epilepsy may be due to a medical condition or injury that affects the brain. Or the cause may be unknown (idiopathic).
Common causes of epilepsy include:
- Traumatic brain injury
- Infections, including meningitis, encephalitis and HIV/AIDS
- Brain injury that occurs during or near birth
- Brain tumor or deformity
- Very high fever
- Withdrawal from drugs
Who is at Risk?
About 2.3 million Americans have epilepsy. The condition affects all age groups but is most common in the very young and the very old. People with a family history of epilepsy are at increased risk of developing the condition.
People with epilepsy generally have a normal lifespan. However they are at risk for health complications such as:
- Accident-related injuries
- Mental health complications
- Learning and memory problems
- Sexual and reproductive health complications
To diagnose epilepsy, a doctor will study the patient’s history, conduct thorough physical and neurological evaluations, and run a variety of tests.
Tests may include:
- Magnetic resonance imaging (MRI) to produce pictures of tissues in the brain
- Electroencephalograph (EEG) to record electrical impulses of the brain
- Electrocardiogram (ECG) to monitor the heart
- Blood tests to exclude other diseases
Brain Mapping to Diagnose Epilepsy
Often times your provider will recommend advanced diagnostic brain mapping to identify seizure origination and to help determine a treatment plan based on those findings.
At the Wake Forest Baptist Comprehensive Epilepsy Center, we have the most sophisticated brain mapping capabilities in North Carolina. Our brain mapping includes analysis based on a variety of information gathered from the patient.
Magnetoencephalography (MEG) is a unique brain imaging technique used at Wake Forest Baptist. MEG measures the magnetic fields emitted by brain cells (neurons), allowing the mapping of brain activity with great precision in real time.
By using this technology, our epilepsy specialists can pinpoint exactly where seizures originate.
The Comprehensive Epilepsy Center offers a six-bed Epilepsy Monitoring Unit (EMU), the most modern in North Carolina, dedicated to confirming a diagnosis of epilepsy and pinpointing seizure activity and origin.
Following diagnosis, your epilepsy team will collaborate with you to determine the best treatment plan. The goal of any epilepsy treatment plan is to control seizures. The plan may include medicines, lifestyle changes, surgery or a combination of those treatments.
Medicines to prevent seizures, called anticonvulsants (or antiepileptic drugs), may reduce the number of future seizures. Epilepsy that does not get better after 2 or 3 anti-seizure drugs have been tried is called “medically refractory epilepsy.” Approximately one-third of patients with epilepsy have seizures that cannot be controlled by medications.
These individuals with medically refractory epilepsy may benefit from dietary treatment, surgical resection or surgically-implanted devices.
Some people are placed on a special diet to help prevent seizures. The most popular being the ketogenic diet. The ketogenic diet is a high fat, low carbohydrate diet that induces a state of false starvation and ketosis.
When medication and dietary treatment alone cannot control seizures, patients are evaluated for other treatment options, including surgical removal of the epileptic focus (where the seizures originate in the brain) or implantation of the vagal nerve stimulator.