Epilepsy is a chronic neurological disease characterized by recurrent seizures. At times, the cause is known, but in almost 50% of patients the cause is unknown. It is not a mental illness or developmental disability, but a condition involving abnormal, hyper excitable electrical disturbances in parts of the brain. This abnormal electrical activity is manifested through a clinical seizure.
Epilepsy can develop at any age though it is especially common in the very young or those over 65. Almost 0.5 to 1% of the population will develop epilepsy.
The primary sign is recurrent seizures, at least 24 hours apart, or a single seizure accompanied by an EEG that suggests high risk for further seizures.
While many people think of a specific kind of episode when they hear the word “seizure” — loss of consciousness, jerking and twitching movements — there are several different types of seizures, each with distinct symptoms.
Focal onset seizures begin in a specific area of the brain and involve localized symptoms.
Generalized onset seizures involve the whole brain and a loss of awareness or consciousness.
While some people with epilepsy will have the same type of seizure each time, many will have different types of seizures during different episodes.
There are many different causes of epilepsy. Historically, no cause can be determined for about half of epilepsy cases, while other cases may be the result of:
Not all people who experience one of these conditions will develop epilepsy, and there is no known way to prevent epilepsy from developing.
First, it’s important to remember that seizures and epilepsy are not the same thing. While every person with epilepsy has seizures, not all people who have seizures are epileptic. Epilepsy is generally diagnosed when a person has had two or more unknown onset seizures more than 24 hours apart. In some cases, an epilepsy diagnosis is made after one seizure, if the patient has certain risk factors that suggest recurrent seizures are likely proven with an abnormal EEG.
Your doctor may order a variety of tests to attempt to determine the cause of your seizures, as well as their likelihood to recur.
Based on certain factors, including (but not limited to) your age when seizures began, the type of seizures you have, your genetic information, and the part of the brain affected, doctors may diagnose a specific epilepsy syndrome to help determine the best course of treatment.
There are a number of treatment options available to help control the severity and frequency of seizures. In the majority of cases, about two-thirds, patients can be controlled by medications. And some carefully selected epilepsy patients are candidates for surgery that can potentially stop the seizures.
In many cases, doctors will prescribe anti-seizure medication to help limit seizure frequency. Medication is the first line of treatment for epilepsy.
If medications alone aren’t effective, your doctor may recommend a surgical treatment (such as vagal nerve stimulation, laser ablation, or surgical resection) or a more invasive surgical option. Each case is different, and each person responds differently to treatment, so it’s important to talk to your doctor about your individual treatment plan.