It is a chronic disorder that causes recurrent unprovoked seizures.
A seizure is a sudden discharge of electrical activity in the brain, which at the time it happens is not easy to control.
There are two main types of attacks related to epilepsy. Generalized seizures affect the entire brain. Focal or partial seizures affect only part of the brain.
A mild epileptic seizure can be difficult to recognize. It may last a few seconds during which you lack consciousness.
The strongest seizures can cause spasms and uncontrollable muscle contractions, and can last from a few seconds to several minutes.
During a stronger seizure, some people become confused or lose consciousness. Afterwards, you may not remember what is happening.
There are several reasons why you might have an epileptic seizure. These include:
- High fever
- Head trauma
- Very low blood sugar
- Abstinence from alcohol
Statistics regarding epilepsy.
Epilepsy is a fairly common neurological disorder that affects 65 million people worldwide. In the United States, it affects around 3 million people.
Anyone can develop epilepsy, but it is more common in young children and older adults. It happens a little more in men than in women.
There is no cure for epilepsy, but the disorder can be treated with medications and other strategies.
What are the symptoms?
Seizures are the main symptom of epilepsy. Symptoms vary from person to person and according to the type of attack.
Focal attacks (partial)
A simple partial attack does not imply loss of consciousness. Symptoms include:
- Alterations in the sense of taste, smell, sight, hearing or touch
- Tingling and contractions of extremities
- Complex partial seizures involve loss of consciousness or consciousness. Other symptoms include:
- Lost look
- Lack of response
- Performing repetitive movements
- Generalized attacks
Generalized seizures involve the entire brain. There are six types:
- The absence crises, which used to be called “small convulsions”, cause a blank look. This type of attack can also cause repetitive movements, such as snapping the lips or blinking. There is also usually a brief loss of knowledge.
- Tonic seizures cause muscle stiffness.
- Atonic seizures cause loss of muscle control and can cause it to fall suddenly.
- Clonic seizures are characterized by repeated and irregular muscle movements of the face, neck and arms.
- Myoclonic seizures cause rapid and spontaneous spasms of the arms and legs.
- Tonic-clonic seizures used to be called “convulsions of great evil.” Symptoms include:
- Rigidity of the body
- Loss of control of the bladder or bowel
- Biting the tongue
- Loss of consciousness
- After an attack, you may not remember having it, or you may feel slightly ill for a few hours.
What triggers an epileptic seizure?
Some people can identify things or situations that can trigger attacks.
Some of the most frequently reported triggers are:
- Lack of sleep
- Some disease or fever
- Bright lights, intermittent or specific patterns of colors
- Excessive consumption of caffeine, alcohol, medicines or drugs
- Omission of food, overeating or specific food ingredients
Identifying triggers is not always easy. A single incident does not always mean that something is a trigger. It is often a combination of factors that trigger a seizure.
A good way to find your triggers is to keep a diary of events. After each attack, keep in mind the following:
- Day and hour
- In what activity was involved at the time of occurrence
- What was happening around him
- sights, smells or unusual sounds
- Unusual stressors
- What was eating or how much time had passed since he ate
- Your level of fatigue and how well you slept last night
You can also use your event log to determine if your medications are working. Consider how you felt right before and right after your attack and any side effects.
Bring the diary when you visit the doctor. It may be useful to adjust your medications or explore other treatments.
Is epilepsy hereditary?
There may be up to 500 genes related to epilepsy. Genetics can also give you a natural “seizure threshold”.
If you inherit a low seizure threshold, you are more vulnerable to seizure triggers. A higher threshold means you are less likely to have seizures.
Epilepsy sometimes occurs in families. Even so, the risk of inheriting the condition is quite low. Most parents with epilepsy do not have children with epilepsy.
In general, the risk of developing epilepsy at age 20 is about 1 percent, or 1 in 100 people.
If you have a father with epilepsy due to a genetic cause, his risk rises to between 2 and 5 percent.
If your father or mother has epilepsy due to another cause, such as stroke or brain injury, this does not affect your chances of developing epilepsy.
Certain rare conditions, such as tuberous sclerosis and neurofibromatosis, can cause seizures. These are conditions that can occur in families.
Epilepsy does not affect your ability to have children. But some medications for epilepsy can affect your unborn baby.
Do not stop taking your medications, but talk to your doctor before you get pregnant or as soon as you know you are pregnant.
If you have epilepsy and are concerned about starting a family, consider arranging a consultation with a genetic counselor.
For 6 out of 10 people with epilepsy, the cause can not be determined. A variety of things can cause seizures.
Possible causes include: traumatic brain injuries in the brain after a brain injury (posttraumatic epilepsy), severe illness or very high fever, which is the main cause of epilepsy in people over 35 years.
In addition, other vascular diseases of oxygen in the cerebral brain or cystidemia or Alzheimer’s disease, use of maternal drugs, prenatal injury, brain malformation or lack of oxygen in the birth of infectious diseases such as AIDS and meningitis also influence.
Genetic or developmental disorders or neurological diseases may also be relevant. Personality plays a role in some types of epilepsy.
In the general population, there is a 1 percent chance of developing epilepsy before 20 years of age.
If you have a father whose epilepsy is linked to genetics, that increases your risk from 2 to 5 percent.
Genes can also make some people more susceptible to seizures by environmental triggers.
It can develop at any age. The diagnosis usually occurs in early childhood or after 60.
How is it diagnosed?
If you suspect you have had a seizure, consult your doctor as soon as possible. A seizure can be a symptom of a serious medical problem. Your medical history and symptoms will help your doctor decide which tests will be useful.
You will probably have to undergo a neurological examination to evaluate your motor skills and your mental functioning. To diagnose epilepsy, other conditions that cause seizures should be ruled out.
Your doctor may order a complete blood count and blood chemistry.
Blood tests can be used to detect both the presence of signs of infectious diseases and blood glucose levels of the kidney, among other things.
The electroencephalogram (EEG) is the most common test used to diagnose epilepsy.
First, the electrodes are attached to your scalp with a paste. It is a non-invasive and painless test. You may be asked to perform a specific task.
In some cases, the test is done during sleep. The electrodes will record the electrical activity of your brain. Whether you have an attack or not, changes in normal brain wave patterns are common in epilepsy.
Identification tests can reveal tumors and other abnormalities that can cause seizures. These tests may include: Positron emission tomography (PET) and / or single photon emission computed tomography.
It is usually diagnosed if you have seizures for no apparent or reversible reason.
Most people can treat epilepsy promptly. Your treatment plan will be based on the severity of the symptoms, your health, and how well you respond to the therapy.
Some treatment options include:
- Antiepileptic drugs (anticonvulsants): these medicines can reduce the number of attacks you have. In some people, they eliminate seizures. To be effective, the medication must be taken exactly as instructed.
- The use of a vagus nerve stimulator: this device is surgically placed under the skin of the chest and electrically stimulates the nerve that runs down your neck. This can help prevent seizures.
- Ketogenic diet: More than half of people who do not respond to medication benefit from this diet high in fat and low in carbohydrates.
- Wound surgery: the area of the brain that causes seizure activity can be eliminated or altered. Research into new treatments in this regard is ongoing.
- One treatment that may be available in the future is deep brain stimulation. It is a procedure in which the electrodes are implanted in your brain. Then a generator is implanted in his chest. The generator sends electrical impulses to the brain to help decrease seizures.
- Another route of investigation involves a device similar to a pacemaker. It would check the pattern of brain activity and send an electrical charge or medication to stop an attack. They are also investigating a series of minimally invasive surgeries as well as radiosurgery.
Drugs for epilepsy
The first line treatment for epilepsy is anticonvulsant medication. These medications help reduce the frequency and severity of seizures.
However, they can not stop a seizure that is already in progress, nor is it a cure for epilepsy.
The medication is absorbed by the stomach. Then it travels through the bloodstream to the brain. It affects neurotransmitters in a way that reduces the electrical activity that leads to seizures.
Anticonvulsant medications pass through the digestive tract and leave the body through the urine.
There are many anticonvulsant medications on the market. Your doctor may prescribe a single medication or a combination of them, depending on the type of seizures you have.
Common medications for epilepsy include:
- Levetiracetam (Keppra)
- Lamotrigina (Lamictal)
- Topirax (Topamax)
- Valproic acid (Depakote)
- Carbamazepina (Tegretol)
- Etosuximida (Zarontin)
These medications are usually available in tablets, liquids or injections and are taken once or twice a day.
It will start with the lowest possible dose, which can be adjusted until it starts working. These medications must be taken consistently and as prescribed.
Some potential side effects may include:
- Poor coordination
- Memory problems
- In the strangest cases, serious side effects include depression and inflammation of the liver or other organs.
Epilepsy is different for everyone, but most people get better with anticonvulsant medications. Some children with epilepsy stop having seizures and may stop taking medications.
Is surgery an option for the treatment of epilepsy?
If the medication can not decrease the number of attacks, another option is surgery.
The most common surgery is a resection. This involves removing the part of the brain where the attacks begin.
Most often, the temporal lobe is removed in a procedure known as temporal lobectomy. In some cases, this can stop the seizure activity.
In some cases, the individual will be kept awake during this procedure. This is so that doctors can talk to him and avoid removing parts of the brain that control important functions such as vision, hearing, speech or movement.
If the area of the brain is too large or important to eliminate, there is another procedure called multiple cross section or disconnection.
The surgeon makes cuts in the brain to interrupt the nerve pathway. This prevents seizures from spreading to other areas of the brain.
After surgery, some people can reduce anti-seizure medications or even stop taking them.
There are risks to any surgery, including a bad reaction to anesthesia, bleeding and infection. Brain surgery can sometimes result in cognitive changes.
Discuss the pros and cons of the different procedures with your surgeon and seek a second opinion before making a final decision.
The ketogenic diet is often recommended for children with epilepsy. This diet is low in carbohydrates and high in fat. The diet forces the body to use fat as a source of energy instead of glucose, a process called ketosis.
The diet requires a strict balance between fats, carbohydrates and proteins. That is why it is better to work with a nutritionist or dietitian. Children on this diet should be carefully monitored by a medical specialist in the area.
The ketogenic diet does not benefit everyone. But when followed correctly, it is often successful in reducing the frequency of seizures. It works better for some types of epilepsy than others.
For adolescents and adults with epilepsy, a modified Atkins diet may be recommended. This diet is also high in fat and involves a controlled intake of carbohydrates.
Approximately half of adults who try the modified Atkins diet experience fewer seizures. The results can be seen as fast as a few months.
Because these diets tend to be low in fiber and high in fat, constipation is a common side effect.
Talk to your doctor before starting a new diet and make sure you get vital nutrients. In any case, not eating processed foods can help improve your health.
Epilepsy and behavior: is there a connection?
Children with epilepsy tend to have more learning and behavior problems than those who do not. Sometimes there is a connection. But these problems are not always caused by epilepsy.
About 15 to 35 percent of children with intellectual disabilities also have epilepsy. Often, they come from the same cause.
Some people experience a change in behavior in minutes or hours before an attack. This could be related to the abnormal brain activity that precedes an attack, and may include:
Children with epilepsy may experience uncertainty in their lives. The prospect of a sudden seizure in front of friends and classmates can be stressful. These feelings can cause a child to act or withdraw from social situations.
Most children learn to adapt over time. For others, social dysfunction can continue into adulthood.
Between 30 and 70 percent of people with epilepsy also have depression, anxiety or both. Anticonvulsant medications can also have an effect on behavior.
Changing or making adjustments to medications taken for epilepsy can help. Behavioral problems should be addressed during doctor visits.
The treatment will depend on the nature of the problem. You could also benefit from individual therapy, family therapy or join a support group to help you cope.
Living with epilepsy: Expectation
Epilepsy is a chronic disorder that can affect many parts of your body.
Laws vary from place to place, but if your seizures are not well controlled, you may not be allowed to drive. Because you never know when a seizure will occur, many everyday activities, such as crossing a busy street, can become dangerous.
These problems can lead to the loss of independence. Some other complications of epilepsy may include:
Risk of permanent damage or death due to severe seizures lasting more than five minutes (status epilepticus) risk of recurrent seizures without regaining consciousness in the environment (status epilepticus), Sudden and unexplained death in epilepsy, affecting only 1 per hundred of people with epilepsy.
In addition to regular visits to the doctor and following your treatment plan, here are some things you can do to cope: Keep a seizure diary to help identify possible triggers in order to avoid them.
Wear a medical alert bracelet so that people know what to do if they have a seizure and can not speak.
Teach the people closest to you about seizures and what to do in an emergency. Seek professional help for symptoms of depression or anxiety. Join a support group for people with seizure disorders.
Take care of your health by following a balanced diet and exercising regularly.
If there are no definitive cures, how effective are the surgical treatments?
There is no cure for epilepsy, but early treatment can make a big difference. Uncontrolled or prolonged seizures can cause brain damage.
Epilepsy also increases the risk of sudden unexplained death. The condition can be handled successfully. Seizures can usually be controlled with medications.
Two types of brain surgery can reduce or eliminate seizures. A type, called resection, involves removing the part of the brain where the seizures originate.
When the area of the brain responsible for the seizures is too large or too large to remove, the surgeon may perform a disconnection.
This involves interrupting the nerve path by making cuts in the brain. This prevents seizures from spreading to other parts of the brain.
Recent research found that 81 percent of people with severe epilepsy were completely or nearly free of attacks six months after surgery.
After 10 years, 72 percent were still completely or almost without seizures. Dozens of other avenues of investigation into the causes, treatment and potential cures for epilepsy are ongoing.
Although there is no cure at this time, proper treatment can result in improvement in your condition and quality of life. More information on the long-term outlook for people with epilepsy
Facts and statistics
Worldwide, 65 million people have epilepsy. That includes about 3 million people in the United States, where there are 150,000 new cases of epilepsy diagnosed each year. Somehow, up to 500 genes may be related to epilepsy.
For most people, the risk of developing epilepsy before age 20 is about 1 percent. Having a father with genetically related epilepsy increases that risk to between 2 and 5 percent. For people older than 35 years, one of the main causes of epilepsy is stroke.
For 6 out of 10 people, the cause of an attack can not be determined. Between 15 and 30 percent of children with intellectual disabilities have epilepsy.
Between 30 and 70 percent of people who have epilepsy also have depression, anxiety or both. Unexplained occult death affects approximately 1 percent of people with epilepsy.
Between 60 and 70 percent of people with epilepsy respond satisfactorily to the first antiepileptic drug administered to them. About 50 percent can stop taking medications after two to five years without seizures.
A third of people with epilepsy have uncontrollable attacks because they have not found a treatment that works.
More than half of people with epilepsy who do not respond to medication improve with a ketogenic diet. Half of adults who try a modified Atkins diet have fewer seizures.