Resources We Trust Mayo Clinic: Epilepsy Cleveland Clinic: Epilepsy Treating Epilepsy: Understanding the Basics of Epilepsy Centers for Disease Control and Prevention: Epilepsy National Institute of Neurological Disorders and Stroke: Epilepsy and Seizure Disparities Epilepsy Disparities and Inequalities Black American adults are slightly less likely to develop epilepsy than white adults. On the other hand, Hispanic American adults tend to have slightly higher rates of epilepsy than either group. Although there are no significant racial differences in the number of people living with epilepsy in the United States, research suggests that there are differences in how racial and ethnic minorities are treated for epilepsy compared to whites. This may be due to unconscious bias by health care providers or because black and Hispanic Americans are more likely than whites to have no health insurance, making it more difficult to pay for health care. Overall, people with lower socio-economic status are more likely to develop seizures and epilepsy and may be less likely to receive cutting-edge diagnostic approaches, be prescribed antiepileptic drugs, or undergo surgery to control epilepsy. Seizures.e60dc2a1-f33c-4a05-9b50-8e3e8e59762930fa2cf1-461d-43e2-a162-0d4412ef7d7a Causes Causes and risk factors for epilepsy Common causes (also called etiologies) of epilepsy include: Coefficient: e60dc2a1-f33c-4a05-9b50-8e3e8e597629fc329fb2-34b0-4baf-8f99-24d2bf63 1d12e60dc2a1-f33c-4a05-9b50-8e3e8e5976297b0f3654-aeaf-435a-8eb5-fa7b77f59b57Genetic A direct result of known or presumed genetic differences. Structural Caused by changes in the structure of parts of the brain that may be present from birth or caused by head injury, infection, tumor, or stroke. Metabolism If you have a proven metabolic condition, you are at increased risk for epilepsy. Immunology When inflammation of the central nervous system causes epilepsy, such as some types of autoimmune encephalitis. Infectious When infectious diseases such as human immunodeficiency virus, malaria, and tuberculosis cause epilepsy. Unknown if the above causes do not contribute to the cause of epilepsy. Up to half of people with epilepsy do not know the specific cause of their symptoms, even after a complete medical evaluation. In some cases, a combination of these categories may best explain the cause of the seizure. Triggers of epileptic seizures The causes and triggers of epilepsy are different. Seizure triggers do not cause epilepsy, but they can cause epileptic seizures in people who are already susceptible. Common seizure triggers include: e60dc2a1-f33c-4a05-9b50-8e3e8e5976296d6ef452-944b-42df-b95d-d27c060d5afb Stress Lack of sleep Dehydration or lack of food Flashing lights Alcohol or drug intake or withdrawal In most cases of childhood epilepsy, the cause is genetic. Metabolic, or structural problems present at birth. Epilepsy in adults is more likely to be caused by structural changes acquired over time, such as tumors or stroke. Although all forms of epilepsy must be prevented, there are some steps you can take to reduce your risk of developing epilepsy. e60dc2a1-f33c-4a05-9b50-8e3e8e59762978408e73-d6e7-410f-bbed-6bd27a6f2c8f Practice good hygiene to prevent infection An infection called neurocysticercosis is common. It is a cause of epilepsy around the world and is caused by ingesting tapeworm eggs. It is most common in areas of Latin America, Asia, and Africa where sanitary conditions are poor, but it is fairly rare in the United States and Europe. You can reduce the risk of infection by practicing good personal hygiene, such as washing your hands regularly, and practicing safe food preparation methods, such as regularly cleaning kitchen surfaces. Injury Another common cause of epilepsy is traumatic brain injury or head injury. For example, wearing a helmet when playing sports such as hockey, or when riding a skateboard or bicycle can reduce the risk of head injury. It also helps to wear a seat belt when riding in a car and always use a car seat for babies and small children. Reducing Risk Factors for Cardiovascular Disease Reducing your risk of heart attack and stroke can also help lower your risk of developing epilepsy later in life, since some epilepsy is caused by these health events. A heart-healthy diet, regular exercise, and stress management can help maintain heart and blood vessel health. After receiving a diagnosis of epilepsy, the best way to prevent seizures and reduce their frequency is to continue the treatment prescribed by your doctor. If you feel that treatment is not working and your seizures are affecting your quality of life, talk to your doctor about other options. Symptoms Signs and Symptoms of Epilepsy Seizures are the most well-known symptom of epilepsy. Symptoms of epileptic seizures vary widely depending on which type of brain is affected, how much of the brain is affected, and the severity of the effect. Because of this, seizures can range from relatively benign events to life-threatening emergencies. Doctors classify seizures as generalized, focal, or unknown based on where in the brain they begin and the extent of brain activity. Many subtypes of seizures exist within each of these categories. e60dc2a1-f33c-4a05-9b50-8e3e8e5976291ab16d6d-121c-4b56-95c4-ade53287ce27 Generalized Seizures In generalized seizures, abnormal neuronal activity spreads to both halves of the brain, or hemispheres. Generalized seizures have both motor symptoms (motor symptoms) and non-motor symptoms (absence). Example: e60dc2a1-f33c-4a05-9b50-8e3e8e597629b8dd5707-6071-4d58-a688-f10410dee2c6 Absence Seizures Absence seizures can last only a few seconds and are sometimes confused with daydreaming because the person is usually unresponsive during the seizure. Cataplexy These seizures cause the normal resting muscle tone, or tone, to relax. This may appear as if you suddenly collapse or fall to the ground. Myoclonic seizures These seizures cause the body to suddenly tremble and muscles to tense up, feeling as if they were being jolted by electricity. Tonic Seizure In this type of seizure, the person’s muscle tone suddenly tightens and the person loses consciousness. It may fall to the ground, but in a solid manner, resembling a tree trunk more than a rag doll. Clonic Seizures This type of seizure causes a person’s muscles to spasm and twitch. Muscles in the elbows, legs, and neck flex and relax rapidly. Tonic-clonic seizures Formerly known as grand mal seizures, these are the type of seizures that people often associate with epilepsy. The person becomes stiff and muscles begin to spasm. Focal Seizures Focal seizures begin in one part of the brain and remain in only one hemisphere of the brain. Because of this, symptoms are less likely to be as widespread as generalized seizures. Localized symptoms tend to occur on only one side of the body rather than on both sides. Many focal epilepsies have “warning signs,” or symptoms that warn of an upcoming seizure. The person experiencing the aura has consciousness. Symptoms of focal seizures fall into different categories. e60dc2a1-f33c-4a05-9b50-8e3e8e59762932b14486-5d0b-4001-a194-1e17844bc4c9 Movement These symptoms often include jerky movements of the legs, face, arms, or other parts of the body. Sensory Sensory symptoms can affect the sense of hearing and smell, or cause hallucinations. Autonomic Nerves These symptoms affect the parts of the brain responsible for involuntary functions, causing changes in blood pressure, heart rate, and bowel and bladder function. Mental When a focal seizure hits parts of the brain associated with emotion and memory, it can cause feelings of fear, anxiety, and déjà vu. You can also tell the difference between focal seizures by the level of consciousness: e60dc2a1-f33c-4a05-9b50-8e3e8e59762910b701fe-7998-44c6-ac7c-c5809101ee26 Focal consciousness seizures During focal consciousness seizures, a person is awake but frozen and unable to react for up to several seconds. minutes. Afterwards, you will be able to remember the seizure. Focal unconsciousness seizures This type of seizure causes a lack of consciousness. The person may perform an action without realizing what he or she is doing. They may seem like they are dreaming, but they are too surprised to snap out of it. From Focal Seizures to Tonic-Clonic Seizures Some seizures begin as focal seizures of loss of consciousness and progress to generalized tonic-clonic seizures that affect both sides of the brain. Complex and unknown seizures Some epilepsies include both focal and generalized seizures, particularly some childhood syndromes such as Dravet syndrome and Lennox-Gastaut syndrome. Syndrome.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299510652a-d8f0-456b-851f-5caf3fed1826 Doctors may also classify a seizure as having “uncertain onset” when diagnostic tests are inconclusive or the diagnosis is inconclusive. e60dc2a1-f33c-4a05-9b50-8e3e8e59762992c10c97-bc7d-45b4-a5ba-60e336b00ac7 Complications of Epilepsy With early diagnosis and treatment, most people with epilepsy can live long, healthy lives. However, in rare cases or if untreated, it can cause complications, some of which can be fatal. Complications of epilepsy, and the symptoms that commonly occur with it, include: Drowning, falls – occur during or immediately after a seizure. Side effects of antiepileptic drugs Some antiepileptic drugs can cause side effects. Mild side effects include a rash, difficulty concentrating, and fatigue, while severe side effects include a severe rash, suicidal thoughts, and hepatitis. (SUDEP) SUDEP is the leading cause of death in people who experience seizures, with approximately 1 in 1,000 people with epilepsy dying from SUDEP each year. SUDEP is found in otherwise healthy people with epilepsy, even though there is no evidence of seizures. Status epilepticus Status epilepticus is a rare but life-threatening illness in which one or more seizures last longer than 5 minutes, can cause pulmonary, cardiac, or neurological complications and can be fatal for 5 to 40 percent of people who experience it. it.e60dc2a1-f33c-4a05-9b50-8e3e8e5976292fb32994-8bab-4d0a-ae89-518c83f50c1b Attention Deficit/Hyperactivity Disorder (ADHD) Up to about three in four children with epilepsy may show signs or symptoms of ADHD. Most children with epilepsy and ADHD are not hyperactive but have difficulty paying attention and concentrating. migraine, and the two conditions may share some genetic roots. Epilepsy can also cause other types of headaches. e60dc2a1-f33c-4a05-9b50-8e3e8e597629a5ffb66b-4281-4a90-84d5-614f9ba3e393 Epilepsy, stigma and mental health There is some evidence that people with epilepsy experience depression and anxiety at higher rates than the general population. Additionally, people with epilepsy are two to five times more likely to die by suicide. This may be due to the stress of managing the symptoms or the social stigma surrounding epilepsy. e60dc2a1-f33c-4a05-9b50-8e3e8e59762934dcd082-4c01-4ef1-9bb7-f2cb19e008ea Historically, people who experienced seizures were associated with witchcraft and demonic possession, among other folk beliefs. These beliefs and the associated stigma still affect people with epilepsy in some parts of the world. epilepsy can be isolating for children and adults. Friends, family, co-workers, and neighbors may not understand the condition or know what to do when a seizure occurs. Also, if a person with epilepsy is unable to drive, it may be more difficult to contact friends and family. Prognosis How long does epilepsy last? How long epilepsy symptoms last depends on the type of epilepsy and its cause. Medications can help some people with epilepsy, but they don’t have the same effect on everyone. Almost half of epilepsy patients become seizure-free after using the first seizure medication they try. 14 percent of people may become seizure-free after trying a second or third drug. e60dc2a1-f33c-4a05-9b50-8e3e8e5976297a888474-940d-4ce0-ab4e-9e1a787b3d72 About 30 to 40 percent of people with epilepsy have seizures that do not respond to medications. Medication.e60dc2a1-f33c-4a05-9b50-8e3e8e5976290c3169ba-5bcd-4150-aef5-c983e3f83b83 Additionally, more than 6 out of 10 children with epilepsy exceed their growth threshold. Condition.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299a6c1c97-74b5-4374-acde-293a3b037d4e If you have not had a seizure for 2 to 4 years, most doctors will consider reducing the dosage of your seizure medication or possibly discontinuing it. However, many people with epilepsy need to continue taking medication for a long period of time to control their symptoms. Various tests can help find evidence of and diagnose epilepsy and rule out other possible causes of seizures. One of the main tools used to diagnose epilepsy is the electroencephalogram, or EEG. Electroencephalography (EEG) records electrical activity in the brain and can reveal abnormal brain electrical activity that causes epilepsy. Brain imaging using MRI or computed tomography (CT) may also help identify structural brain abnormalities that may be causing seizures. Your medical history can also provide important clues to the underlying cause of your seizures. e60dc2a1-f33c-4a05-9b50-8e3e8e5976291da18958-36af-4bbd-80d1-4f840741d577 Epilepsy Treatment and Medication Options Antiepileptic drugs and antiepileptic drugs are the first-line treatment for epilepsy. . In some cases, options such as nerve stimulation, surgery, and complementary therapies can also be helpful. Medications Most people with epilepsy stop having seizures by taking antiepileptic drugs. Some people need to take a combination of medications to control seizures. Your doctor will likely prescribe a relatively low dose of a single drug to begin with and gradually increase the dose until the seizures are controlled. There are over 20 anti-seizure and antiepileptic drugs, including the following types:e60dc2a1-f33c-4a05-9b50-8e3e8e5976295be6de17-bd75-405e-a0ba-b5e068958424 Brivaracetam Clobazam Clonazepam Carbamazepine Gabapentin lacosamide Lamotrigine Levetiracetam Lorazepam Oxcarbazapine Topiramate Valproic acid Zonisamide There is also evidence that cannabidiol (CBD) can help reduce seizures in children with certain types of epilepsy. To find the right drug, your doctor may consider the following factors: Your specific condition Frequency of seizures Age Co-occurring or pre-existing health conditions Other medications you may be taking Epilepsy is a chronic neurological disease in which the normal chemical and electrical activity between nerve cells in the brain is disrupted. This disorder causes neurons to fire abnormally, causing seizures. During a seizure, many neurons fire at the same time and much faster than normal. e60dc2a1-f33c-4a05-9b50-8e3e8e597629f310eb6a-cb73-4875-bfdb-3f86626d4a46 About 1 percent of U.S. adults have active epilepsy, meaning they have been diagnosed and are taking medication or have had an epileptic seizure. last year. Although epilepsy cannot be cured, it is possible to manage the condition with treatment options such as medication and lifestyle adjustments. Surgery More than half of people with newly diagnosed epilepsy stop having seizures with the first drug. If antiepileptic drugs do not work, your doctor may recommend surgery. Surgery may help if a brain scan shows that the seizures are coming from a small, well-defined area of the brain that can be removed without affecting speech, language, motor function, vision, or hearing. Even after successful surgery, some people may need to continue taking anti-seizure medications to prevent seizures, but the amount of medication can often be reduced with a lower dose. Epilepsy is nerve stimulation that uses electrical pulses to stimulate the vagus nerve or other parts of the brain to stop or prevent seizures. The types of nerve stimulation are: Vagus Nerve Stimulation A device called a vagus nerve stimulator sends pulses of electrical energy to the brain through the vagus nerve, reducing the number and severity of nerve stimulation. Seizure.e60dc2a1-f33c-4a05-9b50-8e3e8e597629651e1722-14ad-4b68-9476-fb59eb493330 Deep Brain Stimulation A neurosurgeon implants electrodes in a specific part of the brain, usually the thalamus. The electrodes are connected to a generator implanted in the chest or skull, which sends electrical pulses to the brain to control seizures. Devices like pacemakers can help stop seizures by detecting them before they occur and sending an electrical charge to the affected part of the brain to stop the seizures. For epilepsy, try alternative and complementary therapies alongside traditional treatments. Acupuncture A traditional Chinese treatment in which a practitioner inserts thin needles into the skin in various parts of the body, acupuncture may reduce the frequency of seizures in some people. people.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296a5f0ee6-0a8b-4c9b-8903-9e735979e747 Vitamin E Studies have shown that people who take antiepileptic drugs and also take vitamin E supplements have fewer seizures and fewer signs of epilepsy in the brain. Electroencephalogram.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a55102a6-adf8-4068-980b-18799f718b5e Ketogenic diet evidence suggests that a ketogenic diet (a high-fat, low-carbohydrate approach) may help control seizures in some children with epilepsy. e60dc2a1-f33c-4a05-9b50-8e3e8e597629c88d87ac-07f6-4ca2-884a-f3aed07bf2bc Types Types of Epilepsy Some types of epilepsy are defined by a set of symptoms characterized as a “syndrome.” In other cases, types of epilepsy are defined by which parts of the brain are involved or affected. Epilepsy syndromes There are dozens of epilepsy syndromes. Some occur alongside or lead to developmental delays, while others do not affect cognitive development. e60dc2a1-f33c-4a05-9b50-8e3e8e597629b8f6bd97-4b0b-4b05-8a9b-e60cc14317ad The most common epilepsy syndromes include: Childhood Absence Epilepsy (CAE) People with this epilepsy syndrome stare for 10 to 20 seconds and then stop abruptly. e60dc2a1-f33c-4a05-9b50-8e3e8e5976295756193d-0013-43d8-9541-d87a370d117b CAE often responds to medical treatment and usually resolves by the next episode. Adolescence.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b8312e0e-90d3-4539-acf6-bf2dbfd6ff28 Juvenile Absence Epilepsy (JAE) JAE Seizures are CAE They tend to last longer than seizures and may be accompanied by generalized tonic-clonic seizures that affect movement. e60dc2a1-f33c-4a05-9b50-8e3e8e597629f6f6e344-7fc9-46ee-ad50-53159468d5b2 Juvenile Myoclonic Epilepsy (JME) Patients with JME may have absence or myoclonic seizures. (muscle spasms) seizures, and generalized tonic-clonic seizures. Children may grow out of JME, but most will need to take medication for the rest of their lives. This type of epilepsy is accompanied by facial spasms and numbness, and seizures often occur at night. In most children, seizures stop by age 15. e60dc2a1-f33c-4a05-9b50-8e3e8e597629dfd82355-9044-4426-80ce-2b2ff581185d Another group of epilepsy syndromes includes those directly related to or induced by epilepsy syndromes. sleep.e60dc2a1-f33c-4a05-9b50-8e3e8e597629fd4f93ef-3584-4889-b953-61d4463604da Additionally, reflex epilepsy syndrome is a rare condition that involves seizures that are triggered by sensory or cognitive triggers. Factors.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b80cf307-2ed6-4a31-98d1-b084c249c106 Epilepsy based on brain region Different parts of the brain function differently, so different symptoms may appear depending on seizure activity in each part. Below are some examples of epilepsy syndromes based on the area of the brain affected. Temporal Lobe Epilepsy (TLE) TLE is often accompanied by feelings of déjà vu, fear, unusual smells or tastes, or a bloated stomach that feels like you’re on a roller coaster. TLE seizures can appear like staring spells or cause repetitive behaviors called automatisms. e60dc2a1-f33c-4a05-9b50-8e3e8e597629272db46f-cd97-4ce5-aa9d-7f4b02a7b284 Frontal Lobe Epilepsy People with frontal lobe epilepsy may have muscle weakness and abnormalities. During a seizure, people may twist their arms or legs, shake their legs, or grimace, as well as psychosis, loss of consciousness, personality changes, or unusual behavior. These attacks often occur during sleep. e60dc2a1-f33c-4a05-9b50-8e3e8e597629a8fe3d9d-a9ed-4b83-8fab-e6f616ec49b3 Neocortical Epilepsy This type of epilepsy affects the neocortex, the outer layer of the brain. Symptoms of seizures can range from abnormal sensations to visual hallucinations, emotional changes, and seizures. e60dc2a1-f33c-4a05-9b50-8e3e8e59762914f0aab1-db61-4c64-b087-6dce50b64b54 Occipital Lobe Epilepsy This rare type of epilepsy is associated with relapses. Seizures caused by the part of the brain responsible for vision. Seizures tend to include visual changes such as flashing lights and hallucinations. e60dc2a1-f33c-4a05-9b50-8e3e8e5976299ac70a4f-ae37-484e-9d55-3308aa2f7cdb Summary Epilepsy is a disease that causes seizures, and its severity can vary from mild to mild. Some types of epilepsy can be life-threatening. Antiepileptic drugs are the standard treatment for epilepsy and allow many patients to live without seizures. Although seizures can seem scary and in some cases dangerous to the person experiencing them, epilepsy is often very manageable with the help of a medical professional.
