About Epilepsy

Epilepsy is the fourth most common neurological disorder in the U.S. after migraine, stroke, and Alzheimer’s disease. Its prevalence is greater than autism spectrum disorder, cerebral palsy, multiple sclerosis and Parkinson’s disease combined. Despite how common it is and major advances in diagnosis and treatment, epilepsy is among the least understood of major chronic medical conditions, even though one in three adults knows someone with the disorder.

Epilepsy affects 3.4 million Americans and 65 million people worldwide.
1 in 26 people will develop it at some point in their lifetime.
In the U.S., it affects more than 300,000 children under the age of 15–more than 90,000 of whom have seizures that cannot be adequately treated.

While medications and other treatments help many people of all ages who live with epilepsy, more than a million people continue to have seizures that can severely limit their school achievements, employment prospects and participation in all of life’s experiences. It strikes most often among the very young and the very old, although anyone can develop epilepsy at any age.

What is Epilepsy?

Epilepsy is a medical condition that produces seizures affecting a variety of mental and physical functions. It is also called a seizure disorder. When a person has two or more unprovoked seizures, they are considered to have epilepsy. Seizures happen when clusters of nerve cells in the brain signal abnormally, which may briefly alter a person’s consciousness, movements or actions.

Types of Seizures

Seizures are symptoms of abnormal brain function. Below are the different types of seizures:

Focal seizures

Only one area of the brain is involved (with or without loss of consciousness).

Generalized seizures

Involves all areas of the brain. Types include: Absence, Tonic, Atonic, Clonic, Myoclonic, Tonic-clonic

Causes

Seizures (and sometimes epilepsy) are further divided into acute and remote. This sub-classification depends on whether there is active brain disease (an acute cause) or whether the brain abnormality is the result of an injury caused by a previous event (in which case it would be called remote). For example, if a child with meningitis experiences seizures during the illness, they would be termed acute symptomatic seizures. If that same child developed seizures 2 years afterwards, she would be diagnosed as having remote symptomatic epilepsy.

Many acute symptomatic causes of seizures may, if severe enough, continue to produce recurring seizures (chronic epilepsy) later on.

Symptomatic seizures

are called that when they can be linked to identifiable diseases or brain abnormalities.

Cryptogenic seizures

are diagnosed when no cause for the seizures can be found. Idiopathic or primary seizures are diagnosed when a genetic (or family) cause for the seizures is suspected. When it is necessary to classify epilepsy according to cause, similar terms are used.

With the exception of very young children and the elderly, the cause of the abnormal brain function is usually not identifiable. If a specific diagnosis of cause cannot be made, then the epilepsy will be described according to seizure type or epilepsy syndrome. Below are potential causes of epilepsy.

Newborns

Brain malformations
Lack of oxygen during, or before delivery, or at birth.
Low levels of blood sugar, blood calcium, blood magnesium or other electrolyte disturbances
Inborn errors of metabolism (chemical disorders)
Intracranial hemorrhage (bleeding in the brain)
Maternal drug use

Infection

Infants and Children
Fever (febrile seizures)
Brain tumor (rarely)
Infections
Brain Malformation

Children and Adults

Congenital conditions (Down syndrome; Angelman’s syndrome; tuberous sclerosis and neurofibromatosis)
Genetic factors (Primary seizure disorders)
Progressive brain disease (rare)
Head trauma

Elderly

Stroke
Alzheimer’s disease
Head trauma

Treatment

When the doctor has made a diagnosis of seizures or epilepsy, the next step is to select the best form of treatment. If the seizure was caused by an underlying correctable brain condition, surgery may stop seizures. If epilepsy — that is, a continuing tendency to have seizures — is diagnosed, the doctor will usually prescribe regular use of seizure-preventing medications. If drugs are not successful, other methods may be tried, including surgery, implanted devices including vagus nerve stimulation (VNS) and Responsive Neurostimulation (NeuroPace), or epilepsy diets (ketogenic diet and modified atkins diet) and complementary therapy. The goal of all epilepsy treatment is to prevent further seizures, avoid side effects, and make it possible for people to lead active lives.