Epilepsy is a chronic disorder of the brain characterized by recurrent seizures (fits). These brief episodes of involuntary movement may involve a part of the body or the whole body. During epileptic seizures, the patient might lose consciousness and the control of bladder or bowel function. The most common type of epilepsy – idiopathic epilepsy – has no identifiable cause. The cause of secondary epilepsy (symptomatic epilepsy) is known; this type is, in general, more common in people over 60 years of age.
The disease is caused by abnormal activity in brain cells. Therefore seizures may affect any process the brain coordinates.
Signs might be:
- Jerking movements of arms and legs that cannot be controlled
- Disturbances of vision, hearing, taste, and mood
- Temporary confusion
- Loss of consciousness or awareness
- Psychic symptoms
Symptoms vary depending on the type of seizure. In most cases, the patient tends to have the same type of seizure each time, i.e. the symptoms are similar from episode to episode.
Physicians classify seizures as either focal or generalized, based on how the abnormal brain activity starts. Focal (partial) seizures appear to result from abnormal activity in just one area of the brain. There are focal seizures without loss of consciousness (simple partial seizures), and focal dyscognitive seizures (complex partial seizures).
Generalized seizures seem to involve all areas of the brain. There are six types: absence, tonic, atonic, clonic, myoclonic, tonic-clonic seizures. Tonic-clonic seizures are the most dramatic, and may result in abrupt loss of consciousness, body stiffening, shaking, and loss of bladder control.
Mostly, no cause of this type of epilepsy is found. Quite a few researchers are convinced that small genetic changes in the brain could be the cause of epilepsy. Current research is searching defects in certain genes that might affect electrical transmission in the brain.
Symptomatic epilepsy may be caused by:
- Cerebrovascular disease, e.g. stroke
- Brain tumors
- Severe head injury
- Drug abuse
- Too much alcohol
- Infection damaging the brain, e.g. meningitis
- Problems during birth causing a baby to be deprived of oxygen
- Parts of the brain that don’t develop properly
Certain circumstances may sometimes precede a seizure, such as:
- Lack of sleep
- Not eating well, low blood sugar
- Excess caffeine or other products that might aggravate seizures
- Certain medicaments
- Not taking the prescribed medications in the correct way
- Illegal drugs
- Menstrual period
- Flashing bright lights or patterns
All those who keep a seizure diary may notice some potentially avoidable things that seem to trigger the symptoms.
During a seizure, the affected person might:
- Fall down and injure her/his head or break bones
- Drown while bathing or swimming
- Have a car or bike accidents
- Get hurt while using an electric cutting knife
- Be trapped in the bathroom after having locked the door
- Have complications if pregnant
In general, psychological problems often occur in patients suffering from epilepsy, such as anxiety and depression. In the worst case they are suicidal.
Epilepsy cannot be cured normally, but medicaments mostly control seizures effectively. One predictor of long-term outcome might be the number of seizures that occur in the first six months. Other factors that can increase the risk of a poor outcome might include little response to the initial treatment, generalized seizures, a family history of epilepsy, psychiatric problems, etc.
Normally, physicians start the therapy with medications. If the patient's condition does not improve, the doctors might suggest surgery or another type of treatment.
Quite a few people with epilepsy may become seizure-free by taking anti-epileptic medication. Other patients can decrease the frequency and intensity of their seizures by using a combination of medications. Many children with epilepsy who aren't experiencing symptoms may discontinue medications after a while and live a life free of seizures.
In the beginning of the treatment, the doctor often prescribes a single medication at a relatively low dosage. Until the patient’s seizures are well-controlled, he might increase the dosage gradually. Anti-seizure medications can have some side effects.
Idiopathic epilepsy (a group of epileptic disorders that are believed to have a strong underlying genetic basis) is not preventable. However, epilepsy with a known cause (secondary epilepsy / symptomatic epilepsy) might be prevented by:
- Avoiding head injuries
- Adequate perinatal care to reduce birth injury
- Drugs and other methods to lower the body temperature of a child with fever in order to reduce the likelihood of febrile seizures
- Avoiding central nervous system infection (common cause of epilepsy in tropical areas)
People with epilepsy can control their condition by:
- Managing stress
- Getting enough sleep
- Reducing alcohol intake
- Drinking enough water, especially during sport
- Not smoking
- Taking medication as prescribed by the doctor
- Exercising (may also reduce depression)
- Educating friends, family, colleagues about epilepsy and what to do when a seizure happens and they are around
- Living as independently as possible