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Alternative names Return to top
Seizure disorderDefinition Return to top
Epilepsy is a brain disorder involving recurrent seizures.Causes, incidence, and risk factors Return to top
Epilepsy is a disorder involving repeated seizures of any type. Seizures ("fits") are episodes of disturbed brain function that cause changes in attention and/or behavior. They are caused by abnormal electrical excitation in the brain.
Sometimes, seizures are related to a temporary condition, such as exposure to drugs, withdrawal from certain drugs, or abnormal levels of sodium or glucose in the blood. In such cases, repeated seizures may not recur once the underlying problem is corrected.
In other cases, injury to the brain (e.g., stroke or head injury) causes brain tissue to be abnormally excitable. In some people, an inherited abnormality affects nerve cells in the brain, which leads to seizures. In some cases, no cause can be identified.
Some of the more common causes of seizures include:
Seizure disorders affect about 0.5% of the population. Approximately 1.5-5.0% of the population may have a seizure in their lifetime. Epilepsy can affect people of any age.
Risk factors include a family history of epilepsy, head injury, or other condition that causes damage to the brain.
The following factors may present a risk for worsening of seizures in a person with a previously well-controlled seizure disorder:
Symptoms Return to top
The severity of symptoms can vary greatly from simple staring spells to loss of consciousness and violent convulsions. For many patients, the event is stereotyped (the same thing over and over) while some patients have many different types of seizures that cause different symptoms each time.
The type of seizure a person experiences depends on a variety of factors, such as the part of the brain affected, the cause, and individual response.
An aura consisting of a strange sensation (such as tingling, smell, or emotional changes) occurs in some people prior to each seizure. Seizures may occur repeatedly without explanation.
SYMPTOMS OF GENERALIZED SEIZURES
Generalized seizures affect all or most of the brain. They include petit mal and grand mal seizures.
Petit mal seizures:
SYMPTOMS OF PARTIAL SEIZURES
Partial seizures affect only a portion of the brain.
Simple partial (focal) seizures:
Signs and tests Return to top
The diagnosis of epilepsy and seizure disorders requires a history of recurrent seizures of any type. A physical examination (including a detailed neuromuscular examination) may be normal, or it may show abnormal brain function related to specific areas of the brain.An electroencephalograph (EEG), a reading of the electrical activity in the brain, may confirm the presence of various types of seizures. It may, in some cases, indicate the location of the lesion causing the seizure. EEGs can often be normal in between seizures, so it may be necessary to do prolonged EEG monitoring.
Tests may include various blood tests to rule out other temporary and reversible causes of seizures, including:
Treatment Return to top
For treatment of seizures, please see Seizures - first aid.
If an underlying cause for recurrent seizures (such as infection) has been identified, the cause should be treated, and this may stop the occurrence of further seizures. This may include surgical repair of tumors or brain lesions, or other treatments.
Oral anti-convulsants may reduce the number of future seizures. Response is individual, and the medication used and dosage may have to be adjusted repeatedly. The type of medicine used depends on the seizure type, as some seizure types respond well to one medication and may respond poorly (or even be made worse) by others.
The need for follow-up depends on the seizure type and medications used. Some medications need to be monitored for side effects and blood levels.
For some patients, the use of several medications may still be inadequate. This is called refractory epilepsy. Some such people may benefit from brain surgery to remove the abnormal brain cells that are causing the seizures. For others, a vagal nerve stimulator is implanted in the chest, which can help reduce the number of seizures.
Patients should wear medical alert jewelry so that prompt medical treatment can be obtained if a seizure occurs.Support Groups Return to top
The stress caused by having seizures (or being a caretaker of someone with seizures) can often be helped by joining a support group. In these groups, members share common experiences and problems. See epilepsy - support group.Expectations (prognosis) Return to top
Epilepsy may be a chronic, lifelong condition. In some cases, the need for medications may be reduced or eliminated over time. Certain types of childhood epilepsy resolve or improve with age. A seizure-free period of 4 years may indicate that reduction or elimination of medications is possible.Complications Return to top
Calling your health care provider Return to top
Call your local emergency number (911) if this the first time a person has had a seizure or a seizure is occuring in someone without a medical ID bracelet (instructions explaining what to do). In the case of someone who has had seizures before, call the ambulance for any of these emergency situations:
Call your health care provider if any new symptoms occur, including possible side effects of medications (drowsiness, restlessness, confusion, sedation, or others), nausea/vomiting, rash, loss of hair, tremors or abnormal movements, or problems with coordination.
Prevention Return to top
Generally, there is no known way to prevent epilepsy. However, adequate diet and sleep, and abstinence from drugs and alcohol, may decrease the likelihood of precipitating a seizure in people with epilepsy.
Reduce the risk of head injury by wearing helmets during risky activities; this can help lessen the chance of developing epilepsy.
Update Date: 7/2/2004 Updated by: Joseph V. Campellone, M.D., Division of Neurology, Cooper University Hospital, Camden, NJ. Review provided by VeriMed Healthcare Network.
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Page last updated: 28 October 2004 |