Epilepsy is a chronic neurological disorder in which brain cells (neurons) misfire producing sudden, unpredictable, excessive pulses of electrical energy in the brain that cause seizures to happen. Epilepsy is also known as a seizure disorder.
WHAT IS AN EPILEPTIC SEIZURE?
An epileptic seizure is a temporary disruption of the electrical system of the brain that can affect the whole brain and disrupt consciousness or affect only part of the brain which may or may not disrupt consciousness. They produce changes in:
– Movement
– Sensation
– Behavior
– Awareness
WHAT TYPES OF EPILEPTIC SEIZURES ARE THERE?
Generalized Seizures
- Involve the whole brain
- Two common types include absence
and tonic-clonic
- Symptoms may include convulsions,
staring, muscle spasms and falls
Partial Seizures
- Involve only part of the brain
- Two common types include simple
partial and complex partial
- Symptoms depend on the part of the brain
affected
WHAT CAUSES EPILEPSY?
For 70% of epilpesy cases, the cause is unknown.
For the remaining 30% common identifiable causes include:
– Brain trauma (head injuries)
– Brain lesions (e.g. tumors)
– Poisoning (lead)
– Infections of the brain (e.g. meningitis, encephalitis, measles)
– Brain injury at birth
– Abnormal brain development
HOW IS EPILEPSY DIAGNOSED?
Many times a description of an event either by the patient or by a family member or caregiver is sufficient to make a diagnosis of epilepsy. When more information is needed for an accurate diagnosis, further testing of the patient may be required. Once a specific seizure type(s) is confirmed, treatment is prescribed.
WHAT IS THE TREATMENT FOR EPILEPSY?
- Antiseizure Medications (AED’s)
- Surgery
- Vagus Nerve Stimulator
- Ketogenic Diet
- Alternative Therapies
WHAT ARE SOME OF THE MYTHS & MISCONCEPTIONS ABOUT EPILEPSY?
– Most seizures are medical emergencies
– People are aware they are having a seizure and remember what
happened
– Epilepsy is contagious
– Epilepsy is a form of mental illness
– People frequently die or have brain damage due to a seizure
– A person can swallow his/her tongue during a seizure
HOW MANY PEOPLE HAVE EPILEPSY?
– 2.7 million Americans
– 315,000 students in the United States
– More than 45,000 new cases are diagnosed annually in students
– 1-2 in 100 people will develop epilepsy
– 1 in 10 people will have a seizure in their lifetime
– Epilepsy is the most common treatable disorder of the brain
WHEN IS A SEIZURE A MEDICAL EMERGENCY?
– First time seizure (no medical ID and no known history of seizures)
– Convulsive seizure lasting more than 5 minutes
– Repeated seizures without regaining consciousness
– More seizures than usual or change in type
– Person is injured, has diabetes or is pregnant
– Seizure occurs in water
– Normal breathing does not resume
WHAT ARE ABSENCE SEIZURES?
Absence seizures are generalized seizures that look a lot like daydreaming. There is a pause in activity with blank stare, a brief lapse of awareness and possible a chewing or a blinking motion. They usually last 1 to 10 seconds and may occur many times a day. They may be confused with:
– Daydreaming
– Lack of attention
– ADD, ADHD
WHAT IS A GRAND MAL SEIZURE?
A Grand Mal Seizure, now called a tonic-clonic seizure is a generalized seizure that usually begins with a sudden, hoarse cry and is followed by a loss of consciousness, a fall, and convulsions (stiffening of arms and legs followed by rhythmic jerking). Shallow breathing and drooling may occur. There may be a loss of bowel or bladder control, and occasionally the skin nails, lips may turn blue. They generally last1 to 3 minutes and are usually followed by confusion, headache, tiredness, soreness, difficulty with speech.
WHAT IS FIRST AID FOR A TONIC CLONIC SEIZURE?
– Stay calm and track time
– Check for epilepsy or seizure disorder I.D. (bracelet, necklace)
– Protect person from possible hazards (chairs, tables, sharp objects etc.)
– Turn person on his/her side
– Cushion head
– After the seizure remain with the person until awareness of surroundings
is fully regained
– Provide emotional support
– Document seizure activity
DO NOT…
• Put anything in the patient’s mouth during a seizure
• Hold down or restrain
• Attempt to give oral medications, food or drink during a seizure
WHAT IS A SIMPLE PARTIAL SEIZURE?
With a simple partial seizure, full awareness is maintained. There may be rhythmic movements (isolated twitching of arms, face, legs). There may be sensory symptoms (tingling, weakness, sounds, smells, tastes, feeling of upset stomach, visual distortions). Psychic symptoms (déjà vu, hallucinations, feeling of fear or anxiety, or a feeling they can’t explain) may also occur. They usually last less than one minute, and may be confused with acting out, mystical experience, or a psychosomatic illness. These seizures used to be called an “aura”.
WHAT IS A COMPLEX PARTIAL SEIZURE?
When a person has a complex partial seizure they experience altered consciousness. Their awareness is impaired as well as their ability to respond. They often begin with blank dazed stare and are often followed with automatisms (repetitive purposeless movements). There may be clumsy or disoriented movements, aimless walking, picking things up, nonsensical speech or lip smacking. They often last one to three minutes and may be followed by tiredness, headache or nausea. The person may become combative if restrained. These seizures are often confused with drunkenness, drug abuse or aggressive behavior.
FIRST AID - COMPLEX PARTIAL SEIZURE
• Stay calm, reassure others
• Track time
• Check for medical I.D.
• Do not restrain
• Gently direct away from hazards
• Don’t expect person to obey verbal instructions
• Stay with person until fully alert and aware
• If seizure lasts more than 30 minutes, call for emergency medical help
HOW DO I KNOW IF I AM A CANDIDATE FOR EPILEPSY SURGERY?
A patient may be considered a candidate for epilepsy surgery if their seizures all start in the same part of the brain and that area of the brain does not control any important functions, such as speech, movement and sensations.
WHAT IS A VAGUS NERVE STIMULATOR?
The Vagus Nerve Stimulator (VNS) is a device that is implanted just under the skin in the chest with wires that attach to the Vagus Nerve in the neck. It delivers intermittent electrical stimulation to the Vagus Nerve in the neck that relays impulses to widespread areas of the brain. The VNS is used primarily to treat partial seizures when medication is not effective. There is also a special magnet that can be used to activate the device that may help the person prevent or reduce the severity of an oncoming seizure. Treatment with antiseizure medication usually continues.
WHAT IS THE KETOGENIC DIET?
The Ketogenic Diet is based on a finding that burning fat for energy has an antiseizure effect. It is used primarily to treat severe childhood epilepsy that has not responded to standard antiseizure drugs. The diet includes a high fat content, with no sugar and low carbohydrate and protein intake. Maintaining the diet requires strong family, school and caregiver commitment – no cheating allowed! This is a medical treatment – not a fad diet.
WHAT ABOUT ALTERNATIVE THERAPIES?
Everywhere you turn there are new diet supplements and herbal therapies offered to treat a variety of illnesses. As with all of these alternative treatments, your physician should be consulted before beginning use. Most of these are not approved by the FDA, and many can actually make seizures worse.
HOW SHOULD I DOCUMENT A SEIZURE?
It is always a good idea to keep a log of your seizure events to bring to your office visits with your neurologist. It is helpful for your doctor if you include the following information:
• What did the event look like?
• How long did it last?
• When did it happen? Time? Date? Place?
• How often does it occur?
• Were there signs of a loss of focus?
• Were there events that occurred prior to the episode that may have
contributed?
WHAT ARE NON-EPILEPTIC SEIZURES?
The term non-epileptic event points to a long list of behaviors, movement disorders, and psychological disturbances that can look exactly like a true seizure. Among the most common are seizures that are related to psychological \ emotional difficulties, fainting spells, breath holding spells, gastrointestinal reflux, and disorders of movement. Unusual behaviors are often confused with true epilepsy, especially in infants. Common conditions such as gastro-intestinal reflux in an infant may result in spasm-like movements as the babies respond to unpleasant sensations produced by the reflux of gastric acids. Since managing these other conditions is completely different from that of epileptic seizures, the correct diagnosis extremely important.
HOW CAN I SUCCESSFULLY LIVE WITH EPILEPSY?
1. Understand what epilepsy is and what it is not.
Learn about epilepsy and become a vital part of your own
treatment team.
2. Understand that epilepsy is not who you are but just something you have.
Don’t be afraid to talk to people you trust about your seizures. They just may be the ones to help you when you really need someone.
A support group can offer a place to talk about life’s struggles and learn how others manage theirs
3. Understand that reaching out for help in your community is a sign of strength.
It is not always easy to admit that you need help. But, reaching out to others allows them to reach out to you.
4. Understand that setting life-long goals is important.
Finding a job and keeping a job is a challenge for everyone. Learning
about your community resources can make this a successful journey.
