Epilepsy affects around 50 million people around the world, 3.5 million of which are located in the United States, according to the Centers for Disease Control and Prevention (CDC) (1).

Table of Contents

What is Epilepsy?
Types of Epilepsy
- Generalized-onset Seizures
Symptoms of Epilepsy
Causes of Epilepsy
Risk Factors of Epilepsy
Complications of Living with Epilepsy
Diagnosis of Epilepsy
Treatment Options for Epilepsy
Prevention of Epilepsy
Conclusion

What is Epilepsy?

Epilepsy is a chronic neurological condition in which neurons in the brain don’t signal properly. This is followed by unprovoked and recurring seizures. A seizure is a term used to describe a burst in electrical signals throughout the brain. Human brains are developed to generate small and organized electrical signals to function properly. The reason for these signals is for neurons to communicate with the body through neurotransmitters. In patients with epilepsy, these electrical signals become disrupted and impulsive, leading to recurrent seizures.

The result of experiencing a seizure is often followed by loss of consciousness, sensation or movement.

Types of Epilepsy

Epilepsies are usually divided based on the type of seizure a patient experiences. Seizures are classified based on what area of the brain they happen, the amount of consciousness a person experiences throughout the seizure, and whether or not the individual experiences any muscular movements. In a broad aspect, there are two main groups of seizures:

Focal Onset Seizures: These types of seizures develop in a specific area on one side of the brain. It usually affects a network of cells and is also referred to as partial onset seizures (2, 3). They are usually categorized into two types:
Focal Onset Impaired Awareness Seizures: This subtype usually leads to a loss of consciousness. Movements that occur during this seizure are usually lip smacking, taking part in involuntary actions, chewing, leg movements, or pelvic thrusting (2).
Focal Onset Aware Seizures: Also referred to as simple partial seizures, people experiencing them are usually conscious and alert when experiencing an episode. The duration of these seizures often last less than two minutes. Responsiveness to stimuli varies from person to person when going through a focal onset aware seizure.

Generalized-onset Seizures

Generalized onset seizures might impact the spread of cells on both sides of the brain (2, 4). There are 6 types of generalized seizures, including:

Tonic-clonic seizures: This type is a combination between muscle stiffness (tonic) with rhythmic muscle jerking (clonic). Individuals experiencing these types of seizures go through symptoms such as loss of consciousness, stiffening of the muscle, falling, and jerking. Tonic-clonic seizures can last anywhere from one to five minutes. They can lead to drooling, loss of bladder control and biting the tongue.
Tonic seizures: Tonic seizures are characterized by muscle stiffness in the arms, legs or throughout the entire body. Experiencing such a seizure can lead to falls, losing and gaining awareness, and usually last less than 20 minutes.
Clonic seizures: These are followed by repetitive and rapid muscle jerks.
Myoclonic seizures: Myoclonic seizures are short and come with twitches and shock-like muscle jerks (5).
Absence seizures: These seizures usually lead individuals to a loss of consciousness or a blank stare. It can also be followed by repetitive but minor muscle movements such as lip smacking, eye blinking or hand gestures. It’s more common among children and usually lasts for a couple of seconds.
Atonic seizures: Atonic means a lack of tone and as the word describes it, these seizures are followed by a loss of muscle control. This leads the body to droop or fall. These types of seizures are also known as “drop seizures” or “drop attacks” and typically last for less than 15 seconds.

Understanding the different types of epilepsy seizures is important for doctors to properly diagnose patients. If you or a loved one experiences a seizure, consulting with a healthcare professional is required for a proper treatment plan.

Symptoms of Epilepsy

Epilepsy symptoms vary based on the type of seizure a person experiences. Some common symptoms of epilepsy include:

Temporary Loss of Awareness: Durations where an individual loses or goes in and out of consciousness.
Blank Stares: Staring into space. Blank stares are often followed by a lack of responsiveness (2, 6).
Cognitive Effects: Experiencing confusion, difficulty articulating and slowed thinking (4, 7).
Uncontrolled Muscle Movements: Loss of muscle control or jerking (2, 5).
Gastrointestinal Distress: Stomach issues that are, in some cases, followed by goosebumps or feeling hot or cold (8).
Automatisms: Uncontrolled movements such as chewing, lip-smacking, hand motions or other repetitive movements (2, 9).
Sensory Changes: Altered sensations when it comes to hearing taste, smell or feeling numbness or tingling in certain areas of the body (2, 10).
Psychic Symptoms: Feeling scared, anxious or experiencing déjà vu (9, 11).
Physiological Responses: Increased breathing or rapid heartbeat (12, 13).

It’s important to keep in mind that people experience a certain set of these symptoms depending on the type of seizure that they go through.

Causes of Epilepsy

The exact cause of epilepsy continues to remain a mystery for scientists. However, according to research, there are certain potential factors that might increase the risk of developing the condition. Some notable causes are:

Genetics: Some types of epilepsy such as juvenile myoclonic epilepsy and childhood absence epilepsy, are more prone to being caused by genetic predisposition (14).
Head Injuries: Trauma around the head area may lead to seizures (15).
Mesial Temporal Sclerosis: The formation of scars in the temporal lobe of the brain may increase the chances of experiencing seizures (16, 17).
Immune Disorders: Autoimmune disorders that target brain cells may lead to seizures (18).
Malformations of Brain development: Birth abnormalities tied to the lack of brain development may lead to developing epilepsy. Some examples are focal cortical dysplasia and tuberous sclerosis (19).
Brain Infections: Many brain infections such as meningitis and encephalitis are known to increase the risk of experiencing seizures (20, 21, 22).
Brain Conditions and Vascular Abnormalities: Having a brain tumor or experiencing a stroke are linked to epilepsy (23, 24).
Metabolic Disorders: Some metabolic conditions are known to increase the risk of epilepsy (25).

By understanding these potential causes, healthcare professionals can come up with better treatment plans to help those with epilepsy manage their symptoms.

Risk Factors of Epilepsy

The reason for half of all epilepsy cases remains unknown, according to the World Health Organization (WHO) (1) . However, there are some risk factors that can contribute to the onset of this condition, such as:

Family History: People with a family member that suffers from epilepsy have an increased risk for developing the condition themselves (26).
Age: Even though epilepsy typically starts at a young age, the condition may develop at any age (27).
Stroke and Vascular Diseases: Some health conditions such as stroke and other vascular diseases can cause damage to the brain and potentially increase the risk of seizures (28, 29).
Dementia: People with dementia are also at a higher risk of developing epilepsy (30).
Brain Infections: Some brain infections such as meningitis can harm the brain and increase the risk of epilepsy (31, 32).
Seizures in Childhood: Children that go through febrile seizures are more at risk of having epilepsy. The risk remains high during the entire follow-up but is particularly high shortly after the first febrile seizure (33).
Head Injuries: Head injuries are linked to some cases of epilepsy. Traumatic brain injury has been recognized as a cause of epilepsy since antiquity, and it remains one of the most common and important causes of acquired epilepsy today (7).

Even though these risk factors raise awareness about the development of epilepsy, it’s important to note that everyone’s experience with this condition is different. Having a support system and communicating with a healthcare provider may help individuals suffering with epilepsy minimize seizures.

Complications of Living with Epilepsy

Having epilepsy comes with its unique set of challenges and potential complications that may affect daily functioning. Here are some potential complications of people living with epilepsy:

Car accidents: Seizures that are followed with a loss of consciousness can be life threatening while driving. Some U.S. states have restricted driving to some degree for those with epilepsy.
Drowning: People that suffer from epilepsy are at higher risk of drowning when bathing or swimming. This is due to the risk of experiencing a seizure while in the water (34).
Falling: Seizures can lead to falls, which may increase the chances of experiencing head trauma or broken bones (35).
Sleep disturbances: Individuals with epilepsy are more prone to have a bad relationship with sleep, such as trouble falling asleep or staying asleep. This can impact overall wellbeing (36).
Memory issues: Some types of epilepsy are known to cause trouble with memory, which may impact daily life (4).
Pregnancy complications: Experiencing seizures while pregnant may be dangerous for both the mother and the baby. Also, taking anti-seizure medication can increase the risk of the child being born with birth defects. Planning pregnancy under medical supervision is crucial to minimize the risk that comes from having epilepsy (37).

Dealing with the potential complications that come with epilepsy can be both frightening and challenging. However, seeking support from loved ones, healthcare providers and others that suffer with the same condition can make a big difference in minimizing these complications.

Diagnosis of Epilepsy

If you believe you have experienced a seizure, it’s important to talk to a doctor. Seizures can also be a sign of another underlying condition that needs medical attention. Upon setting an appointment with your doctor, they might ask to see your medical history and ask for symptoms experienced during the seizure. This is done to decide which tests you should take for the diagnosis.
You might then go through a neurological examination that will check your mental capabilities and motor skills. Before diagnosing epilepsy, your doctor might also rule out other potential causes of seizures by running blood tests. Blood tests can detect:

Liver and kidney function
Blood glucose levels
Signs of infectious diseases

The most common test for epilepsy diagnosis is an Electroencephalogram (EEG). This is a painless and quick procedure that can detect any abnormal patterns in the brain. It’s common for your doctor to ask you to perform some simple tasks during an EEG. In certain cases, an EEG may be done while you’re asleep. Other tests that your doctor may ask for are:

Blood chemistry analysis
White blood count analysis
Additional EEGs
CT scan (computed tomography scan)
MRI (magnetic resonance imaging)

It’s common for epilepsy to be diagnosed if you have experienced two or more seizures at least 24 hours apart (2). Epilepsy can also be diagnosed after experiencing one seizure. However, such diagnosis is rare due to the inaccuracy. Seeking help after experiencing one or more seizures is important to check if you have epilepsy and get the proper treatment to manage symptoms that come with the condition.

Treatment Options for Epilepsy

Finding and sticking to a treatment plan that works best for people with epilepsy may be overwhelming in some cases. However, understanding the treatment options available can be empowering and provide hope for individuals with the conditions. A treatment plan is usually tailor made to meet a person’s specific needs depending on the type of seizures they have, the intensity of symptoms and the overall health of the individual seeking treatment. Here are some treatment options for epilepsy to better manage its symptoms:

Medication: Antiseizure medication is the most common way patients manage treatments. They are typically used to reduce frequency or even stop seizures altogether in some cases. The way that antiseizure medication works is by regulating neurotransmitters in the brain. The key to finding relief with these medications is using them consistently as your doctor prescribes. There are many antiseizure medications available specifically designed for different types of seizures. Your doctor can recommend or prescribe the right medications based on the type of epilepsy you are diagnosed with. If a medication proves ineffective, talk to your doctor to switch and try out an alternative that proves more effective (38).
Rescue Medications: In emergency cases, some types of medication can help stop the severity of a seizure. These types of medication are usually taken nasally, orally, sublingually, buccally, or rectally and should only be taken under certain circumstances (39).
Brain Surgery: If medications fail to be effective, brain surgery may be considered as an option. Doctors can perform surgery by altering or removing the part of the brain that causes seizures. Even though brain surgery may offer promising results, they do come with risks that require consideration before deciding whether or not it’s the best option (40).
Ketogenic Diet: For people where medication proves ineffective and are also unqualified for brain surgery, going on a ketogenic diet might be something worth considering. Research has shown that a diet low in carbohydrates and high in fat have eased symptoms for people that suffer with certain types of seizures (41).
Other treatment options: Deep brain stimulation can also help people with epilepsy. However, more research is needed for this procedure to be proven effective on patients. This procedure involves implementing electrodes around the head that deliver targeted electrical impulses to the brain (42).

If you have epilepsy, remember that you’re not alone. Your healthcare providers, loved ones and support groups are there to help support you in every step of your journey.

Prevention of Epilepsy

Although most cases of developing epilepsy are beyond a person’s control, taking certain measures can reduce the risk of developing the condition. Minimizing the chances of experiencing a brain injury is the best way to potentially reduce the risk of developing epilepsy. It’s recommended to wear a seatbelt while driving, practice defensive driving, and wear a helmet when biking.

You can also lower the risk of developing epilepsy by making good lifestyle choices such as eating a balanced diet, maintaining a healthy weight, exercising regularly, and drinking in moderation. Also, if you’re suffering from substance abuse seeking treatment and support to become sober can help prevent further damage to the brain.

Avoiding Seizure Triggers

People that suffer with epilepsy often report that there are certain triggers that result in them experiencing a seizure. However, avoiding these triggers altogether doesn’t promise avoiding seizures altogether (43). It may only help reduce them in certain cases. Some of these triggers include:

Insufficient sleep
Certain drugs
Flickering lights
Alcohol consumption
Menstruation
Illness
Stress
Overheating

Identifying Your Seizure Triggers

Some people notice that their seizures have a pattern, occuring at specific times of the day or in certain environments. Keeping a diary and tracking your seizures can help identify what triggers your seizures.

Keep track of the time your seizure takes place, your emotional state and the environment you are in. For example, if you suspect that caffeine might trigger your seizures, carefully monitor whether or not you experienced a seizure right after drinking a cup of coffee.

Questions to Discuss with Your Doctor

If you have been recently diagnosed with epilepsy, make sure to keep open communication with your doctor and asking them the following questions in your next appointment:

Could my seizures worsen without medication or other treatments?
What type of epilepsy do I have?
What steps should I take during another seizure?
Do I need a seizure action plan?
What side effects might I experience from medication, and how should I manage them?
Do you recommend swimming or any other activity related to being in water?
Should I drink alcohol?
Is it safe for me to drive?
How should I tell my friends, family, and coworkers about my condition?
Are there local support organizations for epilepsy that I can reach out to?

Living with epilepsy can come with challenges, but if you take the right steps in getting treated, you can find many effective ways to successfully manage your condition. Remember, there are tools and resources out there that can help you navigate this journey with confidence.

Conclusion

Epilepsy is a condition that can be overwhelming and even frightening in some situations. However, it’s important to keep in mind that you are not alone. There are millions of people experiencing epilepsy around the world. Although seizures can disrupt daily functioning, they certainly do not define who you are.

Apart from the challenges it brings, most people with epilepsy live fulfilling lives after finding the right treatment plan that works for them. The most important thing is to be patient and practice self-compassion even when things don’t work out. With the right support system and having a positive mindset you can overcome the challenges that epilepsy brings and thrive.

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