Epilepsy

Alternative Names

Temporal lobe epilepsy; Seizure disorder

What is Epilepsy

Epilepsy is a brain disorder involving repeated, spontaneous seizures of any type. Seizures are episodes of disturbed brain function that cause changes in attention or behavior. They are caused by abnormally excited electrical signals in the brain.

Signs and symptoms

Almost any type of behavior that happens repetitively may represent a seizure.

• Generalized seizures: All areas of the brain (the cortex) are involved in a generalized seizure. Sometimes these are referred to as grand mal seizures.
• To the observer, the person experiencing such a seizure may cry out or make some sound, stiffen for some seconds, then have rhythmic movements of the arms and legs. Often the rhythmic movements slow before stopping.
• Eyes are generally open.
• The person may not appear to be breathing. The person is often breathing deeply after an episode.
• The return to consciousness is gradual and should occur within a few moments.
• Loss of urine is common.
• Often people will be confused briefly after a generalized seizure.
Partial or focal seizures: Only part of the brain is involved, so only part of the body is affected. Depending on the part of the brain having abnormal electrical activity, symptoms may vary.
• If the part of the brain controlling movement of the hand is involved, for example, then perhaps only the hand may show rhythmic movements or jerking.
• If other areas of the brain are involved, symptoms might include strange sensations or small repetitive movements such as picking at clothes or lip smacking.
• Sometimes the person with a partial seizure appears dazed or confused. This may represent a partial complex seizure. The term complex is used by doctors to describe a person who is between being fully alert and unconscious.
Absence or petit mal seizures: These are most common in childhood.
• Impairment of consciousness is present with the person often staring blankly.
• Repetitive blinking or other small movements may be present.
• Typically, these seizures are brief, lasting only seconds. Some people may have many of these in a day.
• Other seizure types exist, particularly in very small children.

Possible complications

Complications of epilepsy include:

• Aspiration pneumonia
• Depression
• Learning disabilities
• Mallory-Weiss tear
• Medication side effects
• Status epilepticus (Seizure that lasts longer than 30 minutes)
• Rhabdomyolysis

What causes

Potential Causes of Epilepsy in:

Newborns

• Brain malformations
• Lack of oxygen during birth
• Low levels of blood sugar, blood calcium, blood magnesium or other electrolyte disturbances
• Inborn errors of metabolism
• Intracranial hemorrhage
• Maternal drug use
• Infection

Infants and Children

• Fever (febrile seizures)
• Brain tumor (rarely)
• Infections

Children and Adults

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

Elderly

• Stroke
• Alzheimer’s disease
• Trauma

Prevention

You can't prevent epilepsy, but you can do things that reduce your risk for a seizure such as:

• Stop smoking.
• Avoid exposure to secondary smoke.
• Avoid alcohol.
• Avoid caffeine.
• Avoid decongestant medications.
• Do not take nonprescription medications without talking to your doctor first.
• Reduce stress.
• Practice seizure safety.
• Get plenty of sleep.
• Take anticonvulsant medications as directed

Treatment

Treatment for epilepsy usually includes a special diet, patient (and family) education and medications to lessen the frequency of seizures.

Treatment for epilepsy may include:

• Ketogenic diet for seizures
• Medications to control seizures
• Surgery for seizures( Brain stimulator implant)
• Vagus nerve stimulation implant

Medications for epilepsy include:

• Carbamazepine (Tegretol)
• Oxcarbazepine (Trileptal)
• Phenytoin (Dilantin)
• Valproate (Depakote)
• Lamotrigine (Lamictal)
• Ethosuximide (Zarontin)
• Phenobarbital (Barbita, Luminal)
• Primidone (Mysoline)
• Topiramate (Topamax)
• Felbamate (Felbatol)
• Gabapentin (Neurontin)
• Levetiracetam (Keppra)
• Zonisamide (Zonegran)
• Benzodiazepines for seizures
• Clonazepam (Klonopin)
• Lorazepam (Xanax, Ativan)
• Diazepam (Valium)
• Clorazepate (Tranxene)