Epilepsy is a chronic neurological condition characterized by recurrent seizures due to abnormal electrical discharges in the brain. These seizures are caused by uncontrolled electrical activity among brain cells, disrupting muscle control, sensations, emotions, behavior, and awareness.
Epilepsy can affect individuals of any age, race, or gender.
In the United States, approximately 3.4 million people are living with epilepsy, which includes about 3 million adults and 470,000 children. Each year, there are about 150,000 new cases of epilepsy diagnosed in the country.
Understanding Epilepsy
Brain cells communicate through electrical impulses, which are usually orderly and consistent. In individuals with epilepsy, this regular pattern is disrupted by sudden electrical surges, leading to seizures. These interruptions can impact your awareness, emotions, muscle control, and sensations.
Categories of Epilepsy
Epilepsy is classified based on the origin of seizures in the brain, your level of awareness during a seizure, and whether muscle movements occur.
There are primarily two categories of seizures:
Focal Onset Seizures – These seizures begin in a specific area or network of cells within the brain. They are also referred to as partial-onset seizures and can be of two types:
Focal Onset Aware Seizure – During these seizures, you remain conscious and aware. Symptoms include:
- Changes in senses (taste, smell, or sound)
- Emotional fluctuations
- Uncontrolled muscle jerking, typically in the arms or legs
- Seeing flashing lights, dizziness, or tingling sensations
Focal Onset Impaired Awareness Seizure – These seizures may cause confusion or a loss of consciousness or awareness. Symptoms include:
- Staring into space
- Repetitive movements such as blinking, lip-smacking, chewing, hand rubbing, or finger motions
Triggers for Seizures or Epileptic Attacks
Various factors can trigger seizures in individuals with epilepsy, including:
- Stress
- Alcohol consumption, withdrawal, or recreational drug use
- Hormonal changes or menstrual cycles
- Illness
- Flashing lights or patterns
- Poor diet, dehydration, and deficiencies in vitamins and minerals
- Physical exhaustion
- Caffeine
- Dehydration
- Specific times of day or night
- Certain medications
- Skipping doses of anti-seizure medications
- Sleep issues such as insufficient sleep, severe tiredness, disrupted sleep, or sleep disorders like sleep apnea
Symptoms of an Epileptic Seizure
The main symptom of epilepsy is the occurrence of repeated seizures. Symptoms may vary based on the type of seizure:
Possible symptoms include:
- Temporary loss of consciousness or awareness
- Muscle jerking, loss of muscle tone, and uncontrolled muscle actions
- Blank stares or “staring into space”
- Temporary confusion, slow thinking, communication difficulties, or comprehension problems
- Changes in taste, smell, hearing, vision, or tingling or numbness sensations
- Difficulty understanding or speaking
- Goosebumps, temperature changes such as heat or cold waves, and stomach upset
- Lip-smacking, chewing motions, and hand or finger rubbing
Note: Most individuals with epilepsy experience similar symptoms during each seizure because they typically have the same type of seizure every time.
Diagnosing Epilepsy
Epilepsy is generally diagnosed if you experience two or more seizures that are not caused by a known medical condition, such as alcohol withdrawal or low blood sugar.
Your healthcare provider or an epilepsy specialist will perform a physical exam, collect your medical history, and conduct blood tests. Additional assessments and inquiries about your symptoms before and after seizures will be made.
Diagnostic tests may include:
- Electroencephalography (EEG) – This test measures the brain’s electrical activity.
- Brain Scans – MRI scans are used to detect tumors, infections, or abnormalities in the blood vessels.
Managing Epilepsy
Epilepsy management can include anti-seizure medications, specific diets (sometimes in combination with medications), and surgery.
- Anti-seizure drugs include:
- Acetazolamide
- Brivaracetam
- Cannabidiol
- Carbamazepine
- Cenobamate
- Clobazam
- Clonazepam
- Eslicarbazepine acetate
- Ethosuximide
- Everolimus
- Fenfluramine
- Gabapentin
- Lacosamide
- Lamotrigine
- Levetiracetam
- Oxcarbazepine
- Perampanel
- Phenobarbital
- Phenytoin
- Piracetam
- Pregabalin
- Primidone
- Rufinamide
- Sodium valproate
- Tiagabine
- Topiramate
- Valproic acid
- Vigabatrin
- Zonisamide