Epilepsy is a central nervous system (neurological) disorder in which brain activity becomes abnormal, causing seizures or periods of unusual behavior, sensations, and sometimes loss of awareness. Epilepsy is characterized by unpredictable seizures and can cause other health problems.
Epilepsy is a chronic disorder that causes unprovoked, recurrent seizures. A seizure is a sudden rush of electrical activity in the brain.
There are two main types of seizures. Generalized seizures affect the whole brain. Focal, or partial seizures, affect just one part of the brain.
A mild seizure may be difficult to recognize. It can last a few seconds during which the patient lacks awareness. Stronger seizures can cause spasms and uncontrollable muscle twitches, and can last a few seconds to several minutes.
During a stronger seizure, some people become confused or lose consciousness and may not have any memory of it happening afterwards.
Symptoms
Because epilepsy is caused by abnormal activity in the brain, seizures can affect any process that the brain coordinates. Seizure signs and symptoms may include:
- Temporary confusion
- A staring spell
- Loss of consciousness or awareness
- Uncontrollable jerking movements of the arms and legs
- Psychic symptoms such as fear, anxiety or deja vu
Symptoms vary depending on the type of seizure. In most cases, a person with epilepsy will tend to have the same type of seizure each time, so the symptoms will be similar from episode to episode.
Doctors generally classify seizures as either focal or generalized, based on how the abnormal brain activity begins.
Focal Seizures – When seizures appear to result from abnormal activity in just one area of your brain, they’re called focal (partial) seizures. These seizures fall into two categories:
- Focal seizures without loss of consciousness – Once called simple partial seizures, these seizures don’t cause a loss of consciousness. They may alter emotions or change the way things look, smell, feel, taste or sound. They may also result in involuntary jerking of a body part, such as an arm or leg, and spontaneous sensory symptoms such as tingling, dizziness and flashing lights.
- Focal seizures with impaired awareness – Once called complex partial seizures, these seizures involve a change or loss of consciousness or awareness. During a complex partial seizure, you may stare into space and not respond normally to your environment or perform repetitive movements, such as hand rubbing, chewing, swallowing or walking in circles.
Generalized Seizures – appear to involve all areas of the brain are called generalized seizures. Six types of generalized seizures exist.
- Absence Seizures – previously known as petit mal seizures, often occur in children and are characterized by staring into space or subtle body movements such as eye blinking or lip smacking
- Tonic Seizures – Tonic seizures cause stiffening of the muscles
- Atonic Seizures – also known as drop seizures, cause a loss of muscle control, which may cause patient to suddenly collapse or fall down
- Clonic Seizures – associated with repeated or rhythmic, jerking muscle movements. These seizures usually affect the neck, face and arms.
- Myoclonic Seizures – usually appear as sudden brief jerks or twitches of your arms and legs.
- Tonic-clonic Seizures – previously known as grand mal seizures, are the most dramatic type of epileptic seizure and can cause an abrupt loss of consciousness, body stiffening and shaking, and sometimes loss of bladder control or biting your tongue
Triggers
Some people are able to identify things or situations that can trigger seizures.
A few most commonly reported triggers are:
- Lack of sleep
- Illness or fever
- Stress
- Bright lights, flashing lights, or patterns
- Caffeine, alcohol, medicines, or drugs
- Skipping meals, overeating, or specific food ingredients
Causes
Possible causes include:
- Traumatic brain injury
- Scarring on the brain after a brain injury (post-traumatic epilepsy)
- Serious illness or very high fever
- stroke , which is a leading cause of epilepsy in people over age 35
- Dementia or Alzheimer’s disease
- Brain tumor or cyst
- Lack of oxygen to the brain
- Infectious diseases such as AIDS and meningitis
- Genetic or developmental disorders or neurological diseases
Treatments
Anti-epileptic (anticonvulsant, antiseizure) drugs – These medications can reduce the number of seizures you have. In some people, they eliminate seizures. To be effective, the medication must be taken exactly as prescribed.
Vagus nerve stimulator – This device is surgically placed under the skin on the chest and electrically stimulates the nerve that runs through your neck. This can help prevent seizures.
Ketogenic diet – More than half of people who don’t respond to medication benefit from this high fat, low carbohydrate diet
Brain surgery – The area of the brain that causes seizure activity can be removed or altered
Most people can manage epilepsy. Your treatment plan will be based on severity of symptoms, your health, and how well you respond to therapy.
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