There are several types of seizures and each patient will have epilepsy in their own way.
Every function in our bodies is triggered by messaging systems in our brain. What a patient with epilepsy experiences during a seizure will depend on what part of their brain the epileptic activity activates, and how widely and quickly it spreads from that area.
This article will explain the types, symptoms, treatment, and prognosis of epilepsy.
Fast facts on epilepsy
Here are some key points about epilepsy.
- epilepsy is a neurological disorder
- primary symptoms commonly include seizures
- seizures have a range of severity depending on the individual
- treatments include anti-seizure medications
Epilepsy is a neurological condition.
The main symptom of epilepsy is repeated seizures. If one or more of the following symptoms are present, the individual should see a doctor, especially if they recur:
- a convulsion with no temperature (no fever)
- short spells of blackout, or confused memory
- intermittent fainting spells, during which bowel or bladder control is lost, which is frequently followed by extreme tiredness
- for a short period, the person is unresponsive to instructions or questions
- the person becomes stiff, suddenly, for no apparent reason
- the person suddenly falls for no clear reason
- sudden bouts of blinking without apparent stimuli
- sudden bouts of chewing, without any apparent reason
- for a short time the person seems dazed and unable to communicate
- repetitive movements that seem inappropriate
- the person becomes fearful for no apparent reason; they may even panic or become angry
- peculiar changes in senses, such as smell, touch, and sound
- the arms, legs, or body jerk, in babies these will appear as a cluster of rapid jerking movements
The following conditions need to be eliminated as they may present similar symptoms and are sometimes misdiagnosed as epilepsy:
- high fever with epilepsy-like symptoms
- narcolepsy - recurring episodes of sleep during the day
- cataplexy - periods of extreme weakness
- sleep disorders
- panic attacks
- fugue states - rare psychiatric disorder
- psychogenic seizures
Types of epileptic seizures
There are three diagnoses a doctor might make when treating a patient with epileptic seizures:
- Idiopathic - this means there is no apparent cause.
- Cryptogenic - this means the doctor thinks there is most probably a cause, but cannot pinpoint it.
- Symptomatic - this means that the doctor knows what the cause is.
There are three descriptions of seizures, dependant on what part of the brain the epileptic activity started:
A partial seizure means the epileptic activity took place in just part of the patient's brain. There are two types of partial seizure:
- Simple partial seizure - the patient is conscious during the seizure. In most cases, the patient is also aware of their surroundings, even though the seizure is in progress.
- Complex partial seizure - the patient's consciousness is impaired. The patient will generally not remember the seizure, and if they do, their memory will be vague.
A generalized seizure occurs when both halves of the brain have epileptic activity. The patient's consciousness is lost while the seizure is in progress.
Tonic-clonic seizures (previously known as grand mal seizures) - these are perhaps the best known type of generalized seizure. They cause a loss of consciousness, body stiffness, and shaking.
Absence seizures (previously called petit mal seizures) - these involve short lapses in consciousness where the individual appears to be staring off into space. Absence seizures often respond well to treatment.
Tonic seizures - muscles become stiff. They may cause a fall.
Atonic seizures - loss of muscle control, causing the individual to drop suddenly.
Clonic seizures - associated with rhythmic, jerking movements.
Secondary generalized seizure
A secondary generalized seizure occurs when the epileptic activity starts as a partial seizure, but then spreads to both halves of the brain. As this development happens, the patient loses consciousness.
When a diagnosis of seizures or epilepsy is made, the doctor will discuss with the patient or the patient's family what the best treatments are.
If an underlying correctable brain condition is causing the seizures, sometimes surgery can stop them. If epilepsy is diagnosed, the doctor will prescribe seizure-preventing drugs or anti-epileptic drugs.
If drugs do not work, the next option could be surgery, a special diet or VNS (vagus nerve stimulation).
The doctor's aim is to prevent further seizures from occurring, while at the same time avoiding side effects so that the patient can lead a normal, active, and productive life.
Anti-epileptic drugs (AEDs)
The majority of AEDs are taken orally. The type of seizure the patient is having will decide which drug the doctor may prescribe. Patients do not all react in the same way to drugs.
Some drugs may stop seizures in one patient, but not in another. Even when the right drug is found, it can take some time to find the ideal dose.
Is epilepsy common?
About 50 million people worldwide are said to be affected by epilepsy and seizures.
Epilepsy in the United States - according to The Epilepsy Foundation the number of Americans affected by epilepsy and seizures ranges from 1.3 million to 2.8 million.
About 200,000 new cases of seizures and epilepsy occur in the U.S. each year. Ten percent of all Americans will experience a seizure some time during their lifetime.
Epilepsy worldwide - according to The National Society for Epilepsy (UK) about 60 million people have epilepsy globally.
Causes of epilepsy
In many cases, the cause of epilepsy is not known. However, there are some factors that are known to cause epilepsy:
- some people may have genes that make epilepsy more likely to occur
- head trauma - for instance, during a car crash
- brain conditions - including stroke or tumors
- infectious diseases - for instance, AIDS and viral encephalitis
- prenatal injury - brain damage that occurs before birth
- developmental disorders - for instance, autism or neurofibromatosis
The prognosis for epilepsy sufferers
Experts say that about 60 percent of people who are untreated have no further seizures during the 24 months following their first seizure. The outlook (prognosis) for most people with epilepsy is good. Approximately 70 percent go into remission for 5 years on or off treatment (no seizures for 5 years). About 20 to 30 percent develop chronic epilepsy (long term epilepsy).
Life expectancy of people with epilepsy
Researchers from the University of Oxford and University College London, U.K. reported in The Lancet in 2013 that premature death is 11 times more common among people with epilepsy compared to the rest of the population. The authors added that the risk is even greater if a person with epilepsy also has a mental illness. Suicides, accidents, and assaults accounted for 15.8 percent of early deaths; of these, the majority had been diagnosed with a mental disorder.
Head researcher, Seena Fazel said:
"Our results have significant public health implications, as around 70 million people worldwide have epilepsy, and they emphasize that carefully assessing and treating psychiatric disorders as part of standard checks in persons with epilepsy could help reduce the risk of premature death in these patients. Our study also highlights the importance of suicide and non-vehicle accidents as major preventable causes of death in people with epilepsy."