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By Mayo Clinic staff Epilepsy is a disorder that results from the surges in electrical signals inside the brain, causing recurring seizures. Seizure symptoms vary. Some people with epilepsy simply stare blankly for a few seconds during a seizure, while others have full-fledged convulsions. About 2 in 100 people in the United States will experience an unprovoked seizure once in life. However, a solitary seizure doesn't mean you have epilepsy. At least two unprovoked seizures are generally required for an epilepsy diagnosis. Even mild seizures may require treatment because they can be dangerous during activities such as driving or swimming. Treatment — which generally includes medications and sometimes surgery — usually eliminates or reduces the frequency and intensity of seizures. Many children with epilepsy even outgrow the condition with age.
By Mayo Clinic staff Because epilepsy is caused by abnormal activity in brain cells, seizures can affect any process your brain coordinates. A seizure can produce: • • • • Temporary confusion A staring spell Uncontrollable jerking movements of the arms and legs Loss of consciousness or awareness
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 part of the brain, they're called focal or partial seizures. These seizures fall into two categories.
usually affecting the arms. These types of seizures are associated with rhythmic. taste or sound. generally those in your back. arms and legs and may cause you to fall to the ground. • Clonic seizures. causing you to lose awareness for a period of time. • Atonic seizures. Complex focal seizures often result in staring and nonpurposeful movements — such as hand rubbing. these seizures cause you to lose normal muscle tone and suddenly collapse or fall down. When to see a doctor Seek immediate medical help if any of the following occurs: • • • • The seizure lasts more than five minutes. such as an arm or leg. • Tonic-clonic seizures (also called grand mal). • Complex focal seizures. These seizures alter consciousness or awareness. Breathing or consciousness does not return after the seizure stops. swallowing or walking in circles. and spontaneous sensory symptoms such as tingling. body stiffening and shaking. these are characterized by a loss of consciousness.• Simple focal seizures. They may alter emotions or change the way things look. A second seizure follows immediately. Six types of generalized seizures exist. . and can cause a brief loss of awareness. These seizures cause stiffening of the muscles. Generalized seizures Seizures that seem to involve all of the brain are called generalized seizures. feel. These seizures don't result in loss of consciousness. and sometimes loss of bladder control or biting your tongue. • Myoclonic seizures. vertigo and flashing lights. jerking muscle contractions. Also known as drop attacks. • Tonic seizures. They may also result in involuntary jerking of part of the body. chewing. neck and face. You have a high fever. smell. • Absence seizures (also called petit mal). These seizures are characterized by staring and subtle body movement. The most intense of all types of seizures. These seizures usually appear as sudden brief jerks or twitches of your arms and legs.
perhaps by making a person more susceptible to environmental conditions that trigger seizures. Prenatal injury. though it's estimated that up to 500 genes could be tied to the condition. Causes By Mayo Clinic staff Epilepsy has no identifiable cause in about half of those who have the condition. AIDS and viral encephalitis can cause epilepsy. Some types of epilepsy. the condition may be traced to various factors. which are categorized by your type of seizure. making it likely that there's a genetic influence. You've injured yourself during the seizure. If you experience a seizure for the first time. You're pregnant. For most people. • • Head trauma sustained during a car accident or other traumatic injury can cause epilepsy. poor nutrition or oxygen deficiencies. run in families. • Developmental disorders. Diseases such as meningitis. Researchers have linked some types of epilepsy to specific genes. seek medical advice. This can lead to cerebral palsy in the child. • • • Dementia is a leading cause of epilepsy among older adults. Events like strokes or heart attacks that result in damage to the brain also can cause epilepsy. genes are only part of the cause.• • • • You're experiencing heat exhaustion. Epilepsy can sometimes be associated with other developmental disorders. babies are susceptible to brain damage caused by an infection in the mother. You have diabetes. Before birth. • Genetic influence. Medical disorders. In the other half. such as autism and Down syndrome Risk factors . About 20 percent of seizures in children are associated with cerebral palsy or other neurological abnormalities. Stroke is responsible for up to one-half of epilepsy cases in those over age 35.
you're 13 times more likely to drown while swimming or bathing than is the rest of the population because of the possibility of having a seizure while in the water. • Stroke and other vascular diseases. you can injure your head or break a bone.By Mayo Clinic staff Certain factors may increase your risk of epilepsy. • Head injuries. but the condition can occur at any age. you may be at an increased risk of developing a seizure disorder. Seizures during pregnancy pose dangers to both mother and baby. The onset of epilepsy is most common during early childhood and after age 65. Many states have driver's-licensing restrictions related to your ability to control seizures and impose a minimum amount of time that you've been seizure-free — ranging from three months to two years — before you're allowed to drive. • Brain infections. If you have epilepsy. You can reduce your risk by always wearing a seat belt while riding in a car and by wearing a helmet while bicycling. skiing. High fevers in childhood can sometimes be associated with prolonged seizures and subsequent epilepsy later in life. eating a healthy diet and exercising regularly. • Your age. • Car accidents. riding a motorcycle or engaging in other activities with a high risk of head injury. Men are slightly more at risk of developing epilepsy than are women. A seizure that causes either loss of awareness or control can be dangerous if you're driving a car or operating other equipment. Infections like meningitis. and certain anti-epileptic medications increase the risk of birth defects. • Prolonged seizures in childhood. These can lead to brain damage that may trigger epilepsy. can increase your risk of epilepsy. • • Falling. including limiting your intake of alcohol and avoiding cigarettes. Complications By Mayo Clinic staff Having a seizure at certain times can lead to circumstances that are dangerous to yourself or others. If you have a family history of epilepsy. • • Your sex. If you have epilepsy and . Drowning. • Pregnancy complications. which causes an inflammation in the brain or spinal cord. If you fall during a seizure. These injuries are responsible for many cases of epilepsy. A family history. You can take a number of steps to reduce your risk of such diseases. particularly for those with a family history of epilepsy.
talk to your doctor as you plan your pregnancy.000 people with epilepsy die of SUDEP. However. but it's more common among people whose seizures aren't controlled by treatment. Preparing for your appointment By Mayo Clinic staff You're likely to start by seeing your family doctor or a general practitioner. Because there's often a lot of ground to cover. • Status epilepticus. What you can do • Keep a detailed seizure calendar. and the risk over a one-year period could be as high as approximately 1 in a hundred people. anxiety and. especially depression. the type of seizure it was and how long it lasted. increased stress. menstruation or other events that might trigger . less than 1 in 1. This could be due to difficulties dealing with the condition itself as well as medication side effects. Other life-threatening complications from epilepsy are uncommon. it's a good idea to be well prepared for your appointment.you're considering becoming pregnant. People with poorly controlled epilepsy also have a small risk of sudden unexplained death. The risk of SUDEP is particularly elevated when generalized tonic-clonic seizures are frequent. suicide. Also make note of any circumstances. People with epilepsy are more prone to have psychological problems. • Sudden unexplained death in epilepsy (SUDEP). You'll need to be carefully monitored throughout pregnancy. in some cases when you call to set up an appointment. Here's some information to help you get ready for your appointment. and medications may need to be adjusted. in extreme cases. like a neurologist or a doctor called an epileptologist. It's very important that you work with your doctor to plan your pregnancy. sleep deprivation. Most women with epilepsy can become pregnant and have a healthy baby. or you have frequent recurrent seizures without regaining full consciousness in between them. People with status epilepticus have an increased risk of permanent brain damage and death. Overall. who specializes in treating epilepsy. such as missed medications. Each time a seizure occurs. write down the time. but do occur. you may be referred immediately to a specialist. This condition occurs if you're in a state of continuous seizure activity lasting more than five minutes. and what to expect from your doctor. • Emotional health issues.
Seek input from people who may observe your seizures — including family. ask if there's anything you need to do in advance. Make a list of all medications. Also. and will my insurance cover it? Is there a generic alternative to the medicine you're prescribing me? Are there any brochures or other printed material that I can take home with me? What websites do you recommend? .seizure activity. How can I best manage them together? Are there any restrictions that I need to follow? Should I see a specialist? What will that cost. such as restrict your diet. • • • Write down key personal information. For epilepsy. because you may not be aware of everything that happens when you're having a seizure. Sometimes it can be difficult to soak up all the information provided to you during an appointment. • Be aware of any pre-appointment restrictions. • Write down questions to ask your doctor. including any major stresses or recent life changes. Someone who accompanies you may remember something that you missed or forgot. List your questions from most important to least important in case time runs out. your doctor may want to ask questions of someone who has witnessed them. as well as any vitamins or supplements that you're taking. friends and co-workers — so that you can record information you may not know. At the time you make the appointment. some basic questions to ask your doctor include: • • • • • • • • • • • What is likely causing my seizures? What kinds of tests do I need? Is my epilepsy likely temporary or chronic? What is the best course of action? What are the alternatives to the primary approach that you're suggesting? How can I ensure that I don't hurt myself if I have another seizure? I have these other health conditions. Take a family member or friend along. Preparing a list of questions will help you make the most of your time with your doctor.
What to expect from your doctor Your doctor is likely to ask you a number of questions: • • • • • • • When did you first begin experiencing seizures? Do your seizures seem to be triggered by certain events or conditions? Do you have similar sensations just before the onset of a seizure? Have your seizures been frequent or occasional? What symptoms do you have when you experience a seizure? What.In addition to the questions that you've prepared to ask your doctor. Your doctor may take a blood sample to check for signs of infections. if anything. behavior and intellectual capacity to see how the seizures are affecting you. appears to worsen your seizures? What you can do in the meantime Certain conditions and activities can trigger seizures. from neurological exams to imaging techniques like MRI scans. anemia or diabetes. so it is best to: • • • • Avoid excessive alcohol consumption Avoid nicotine and recreational drug usage Get enough sleep Reduce stress Also. it is important to start keeping a log of your seizures before you visit your doctor. electrolyte imbalance. seems to improve your seizures? What. don't hesitate to ask questions during your appointment at any time that you don't understand something. Your doctor may want to test your motor abilities. • Neurological and behavioral exam. • Blood tests. . if anything. Tests and diagnosis By Mayo Clinic staff Your doctor may use a number of tests to diagnose epilepsy. which can be associated with seizures.
• Neuropsychological tests. which help doctors pinpoint where the seizures are originating.Your doctor may also suggest tests to detect abnormalities within the brain. PET scans use a small amount of low-dose radioactive material that's injected into a vein to help visualize active areas of the brain and detect abnormalities. • Computerized tomography (CT). because it's generally a readily available test. it's common to have changes in your normal pattern of brain waves. such as asking you to sleep very little the night before. bleeding and cysts. even when you're not having a seizure. • Positron emission tomography (PET). These include: • Electroencephalogram (EEG). including tumors. CT scans can reveal abnormalities in the brain that might be causing your seizures. • Functional MRI (fMRI). MRIs can reveal brain abnormalities that could be causing your seizures. This group of tests includes IQ. like speech. Sometimes your doctor will have to do something to provoke a seizure while you're being tested. You might be given a CT scan if you go to an emergency room for an initial seizure. A functional MRI measures the changes in blood flow that occur when specific parts of your brain are working. This is the most common test to help diagnose epilepsy. • Magnetic resonance imaging (MRI). so that surgeons can avoid injuring those places while operating. memory and speech assessments. but in far greater detail. This type of test is used primarily if you've had an MRI and EEG that didn't pinpoint the location in your brain where the seizures are originating. MRIs use radio waves and a strong magnetic field to produce detailed images of your brain. An MRI provides much the same type of information as a CT scan. . • Single-photon emission computerized tomography (SPECT). A SPECT test uses a small amount of low-dose radioactive material that's injected into a vein to create a detailed. 3-D map of the blood flow activity in your brain during seizures. This type of testing is routinely done before epilepsy surgery. Doctors generally use an fMRI before surgery to identify the exact locations of critical functions. Your doctor may want to monitor you on video while conducting an EEG of you awake or asleep in hopes of recording the seizure to see what kind of seizures you're having. If you have epilepsy. An EEG records the electrical activity of your brain via electrodes temporarily attached to your scalp with a paste-like substance. CT machines use a type of X-ray equipment to obtain cross-sectional images of your brain and skull.
Mild side effects include: • • • • • • • Fatigue Dizziness Weight gain Loss of bone density Skin rashes Loss of coordination Speech problems More severe but rare side effects include: • Depression . Many adults also can discontinue medication after two or more years without seizures. they may propose surgery or another type of treatment. All anti-seizure medications have some side effects. More than half the children with medicationcontrolled epilepsy can eventually stop medications and live a seizure-free life. Others can decrease the frequency and intensity of their seizures. Medication Most people with epilepsy can become seizure-free by using a single anti-epileptic drug. Finding the right medication and dosage can be complex. Your doctor likely will first prescribe a single drug at a relatively low dosage and may increase the dosage gradually until your seizures are well controlled. If that doesn't work.Treatments and drugs By Mayo Clinic staff Functions of the brain Vagus nerve stimulation Doctors generally start by treating epilepsy with medication.
suicidal thoughts or unusual changes in your mood or behaviors. your doctor may suggest surgery or other therapies. Notify your doctor immediately if you notice new or increased feelings of depression. Talk to your surgeon about his or her experience. Wires from the stimulator are . Always call your doctor before switching to a generic version of your medication or taking other prescription medications. success rates and complication rates with the procedure you're considering. These cuts are designed to prevent seizures from spreading to other parts of the brain. surgery for epilepsy can cause complications such as permanently altering your cognitive abilities. language or hearing. over-the-counter drugs or herbal remedies. your doctor removes the area of the brain that's causing the seizures. well-defined area of your brain that doesn't interfere with vital functions like speech.• • • Suicidal thoughts and behaviors Severe rash Inflammation of certain organs. • • Never stop taking your medication without talking to your doctor. If anti-epileptic medications don't provide satisfactory results. your doctor may recommend a different sort of surgery in which surgeons make a series of cuts in your brain. Surgery Surgery is most commonly done when tests show that your seizures originate in a small. In these types of surgeries. This therapy involves a device called a vagus nerve stimulator that's implanted underneath the skin of your chest like a heart pacemaker. If your seizures originate in a part of your brain that can't be removed. Although many people continue to need some medication to help prevent seizures after successful surgery. Therapies • Vagus nerve stimulation. such as your pancreas or liver To achieve the best seizure control possible with medication: • • Take medications exactly as prescribed. you may be able to take fewer drugs and reduce your dosages. In a small number of cases. At least half of all people newly diagnosed with epilepsy will become seizure-free with their first medication.
This diet. social life. In addition. constipation. which can cause kidney stones. Be sure to get adequate rest every night. This will help emergency personnel know how to treat you correctly. limiting alcoholic beverages and avoiding cigarettes. Consult a doctor if you or your child is considering a ketogenic diet. It's important to make sure that a child doesn't become malnourished when taking the diet. Some children with epilepsy have been able to reduce their seizures by maintaining a strict diet that's high in fats and low in carbohydrates. Some children can go off the ketogenic diet after a few years and remain seizure-free. • Take your medication correctly. These side effects are uncommon if use of the diet is properly and medically supervised. The battery-powered device delivers short bursts of electrical energy to the brain through the vagus nerve. shortness of breath. You can still live an active. Don't take it upon yourself to adjust your dosage levels. Sleep deprivation is a powerful trigger of seizures. talk to your doctor if you feel something should be changed. make healthy life choices such as managing stress. It's not clear how this inhibits seizures. tingling and muscle pain. called a ketogenic diet. • Ketogenic diet. Coping and support By Mayo Clinic staff Uncontrolled seizures and their effect on your life may at times feel overwhelming or lead to depression. coughing. • Get enough sleep. Side effects of vagus nerve stimulation include hoarseness. Instead. slowed growth because of nutritional deficiencies. but the device can reduce seizures by 20 to 40 percent and completely control seizures in about 5 percent of people. Most people still need to take anti-epileptic medication. It's important not to let epilepsy constrain you.wrapped around the vagus nerve in your neck. To help cope: . throat pain. Side effects of a ketogenic diet may include dehydration. causes the body to break down fats instead of carbohydrates for energy. Lifestyle and home remedies By Mayo Clinic staff Understanding your condition can help you control it. • Wear a medical alert bracelet. and buildup of uric acid in the blood.
Don't try to put your fingers or anything else in the person's mouth. • Live as independently as possible.• Educate yourself and your friends and family about epilepsy so that they understand the condition. and connect over the Internet with other people who are interested in the same things. If your seizures are so severe that you can't work outside your home. Put something soft under his or her head. • • Work to develop friends and have contact with other people. If you can't drive because of your seizures. Let people you work and live with know the correct way to handle a seizure in case they're with you when you have one. Sometimes helping others is the best way to help yourself. If the person is moving. • Try to ignore negative reactions from people. This means continuing to work. investigate public transportation options near you. like computer programming. It helps to learn about epilepsy so that you know the facts as opposed to misconceptions about the disease. These include: • • Work from home by developing a special skill. • • Find a doctor you like and with whom you feel comfortable. Stay with the person until medical personnel arrive. No one has ever "swallowed" his or her tongue during a seizure — it's physically impossible. Develop or participate in hobbies. This includes: • • • • Gently roll the person onto one side. Don't attempt to rouse the person by shouting at or shaking him or her. Loosen tight neckwear. And try to keep your sense of humor. . • • • • • Don't try to restrain someone having a seizure. if possible. clear away dangerous objects. Observe the person closely so that you can provide details on what happened. Try not to constantly worry about having a seizure. there are still ways to feel productive and connected to people. Become a volunteer.
• • Time the seizures with your watch. Keep calm and reassure others nearby. .
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