What Is Epilepsy?

brain-focusEpilepsy is a medical condition that produces seizures which affect a variety of mental and physical functions.  It’s also called a seizure disorder. A seizure occurs when a brief, strong surge of electrical activity affects parts or all of the brain. When a person has two or more unprovoked seizures, they are considered to have epilepsy.

Epilepsy is the fourth most common neurological disorder in the United States after migraines, strokes and Alzheimer’s disease.  Its prevalence is greater than autism spectrum disorder, cerebral palsy, multiple sclerosis and Parkinson’s disease combined.  Despite how common the condition is and the major advances in diagnosis and treatment, epilepsy is among the least understood of the major chronic conditions.

  • Anyone can develop epilepsy.  Seizures start for the first time in people over age 65 almost as often as it does in children. Seizures in the elderly are often the aftereffect of other health problems like stroke and heart disease.
  • 65 MILLION: Number of people around the world who have epilepsy.
  • 1 IN 26 people in the United States will develop epilepsy at some point in their lifetime.
  • 6 OUT OF 10: Number of people with epilepsy where the cause is unknown.

 

TYPES OF SEIZURES & EPILEPSY SYNDROMES:

There are many different types of seizures. People may experience just one type or more than one. The kind of seizure a person has depends on which part and how much of the brain is affected by the electrical disturbance that produces seizures.

generalized partial othertypes syndromes terms

  • GENERALIZED:
    • Tonic-Clonic (grand mal):
      • Stiffen, may utter a cry, lose consciousness, fall, body is jerking
      • Lasts 1-3 minutes
      • Lose bladder or bowel control, may vomit
      • Breathing may decrease or cease during a tonic phase
      • After their seizure: confusion, exhaustion, possible agitation or depression, memory loss, should recover 15 minutes – 60 minutes
    • Myoclonic:
      • Brief, shock-like jerks of muscles—usually on both sides of the body at the same time including their neck, shoulder, upper arms, body, and upper legs
      • Usually no loss of consciousness
    • Tonic:
      • Stiffening of the body, arms, or legs
      • Lasts less than 20 seconds and often occurs while they are asleep
      • May lose their balance and fall
      • May lose consciousness
    • Clonic:
      • Jerking, convulsive movements with no stiffening
      • Lose consciousness without confusion or tiredness afterwards
    • Atonic:
      • Sudden loss of muscle tone in head, arm, or body
      • Brief loss of consciousness lasting less than 15 seconds
      • Injury is common (helmets recommended)
    • Absence (petit mal):
      • Brief episodes of staring with impaired awareness and a lack of responsiveness
      • May be eye blinks, chewing movements that last between 10-20 seconds or less
      • Promptly resumes the activity they were in before seizure with no aftereffects but may have no memory of ending and then resuming activity (most common in children)
  • PARTIAL:
    • Simple partial:
      • Auras
      • Change in muscle activity
      • Involuntary contractions
      • Weakness of a body part
      • Changes in sensation (touch, smell, taste, vision, hearing)
      • Change in an area controlling automatic bodily function
      • Changes in how we think, feel and experience things
      • Sense of déjà vu
    • Complex partial:
      • Can include any of the behaviors under simple partial
      • Activity is undirected, dazed appearance, may wander, can’t understand directions or communicate
      • Automatisms (staring, lip chewing, picking at clothes), inappropriate, perhaps socially embarrassing behaviors
      • Lasts from 30 seconds to five minutes, or more
    • Secondary generalized
      • Starts as simple or complex partial, then moves to the whole brain, usually tonic-clonic

OTHER TYPES OF SEIZURES:

EPILEPSY SYNDROMES:

COMMON EPILEPSY TERMS:

  • antiepileptic drugs (AEDs) – medication used to control seizures, also called anticonvulsants.
  • aura – a warning period at the beginning of a seizure, may sense a feeling of fear or doom, or strange sensations such as an odd smell or taste, nausea, or palpitations, but it is actually a simple partial seizure either occurring seconds or minutes before a complex partial or secondarily generalized tonic-clonic seizure, or the simple partial seizure may occur alone without any other seizure following.
  • automatism – purposeless, automatic & involuntary movements during a seizure, such as chewing, lip-smacking, picking at clothing or wandering around confused; may occur during complex partial & absence seizures.
  • catamenial epilepsy – in women, the tendency for seizures to occur around the time of menstruation.
  • corpus callosum – a broad band of nerve fibers joining the two hemispheres of the brain.
  • CT/CAT scan – Computed Tomography/Computerized Axial Tomography; a scanning technique which uses x-rays & computers to produce images of the structure of the brain to help detect abnormalities.
  • EEG – electroencephalogram; a diagnostic test which records the brain’s electrical activity or “brain waves” which does not provide a diagnosis of epilepsy, but can help distinguish types of seizures, or where seizures begin in the brain.
  • epileptogenic zone – a cortical region of the brain that, when stimulated, produces spontaneous seizures or auras.
  • epileptologist – a neurologist with specialty training in epilepsy.
  • focal seizure – an older term for partial seizure, in which the seizure starts in one part of the brain.
  • idiopathic – used to describe an epileptic seizure of unknown cause, as opposed to seizures caused by an identifiable problem in the brain.
  • intractable – difficult to alleviate or remedy; for example, intractable seizures are difficult to control with the usual antiepileptic drug therapy.
  • ketogenic – a high fat, low carbohydrate, low protein diet used to control seizures in children.
  • PET scan – Positron Emission Tomography; a diagnostic test that uses a very low and safe dose of a radioactive compound to measure metabolic activity in the brain; helpful in planning epilepsy surgery
  • post-ictal or postictal – the minutes or hours of abnormal consciousness, confusion or sleepiness after a seizure, during which, the brain is recovering from the seizure & returning to normal function.
  • refractory epilepsy – when a person has failed to become (and stay) seizure free with adequate trials of two seizure medications (antiepileptic drugs/AEDs).
  • responsive neurostimulation (RNS) – new approach to treating medically uncontrolled partial onset seizures; device provides responsive neurostimulation, automatically monitoring brain signals and providing stimulation to abnormal electrical brain events
  • status-epilepticus – a prolonged seizure (usually defined as lasting longer than 30 minutes in a partial seizure, 5 minutes in a tonic-clonic seizure) or a series of repeated seizures; a continuous state of seizure activity, most common with tonic-clonic, but may occur in almost any seizure type, can be life-threatening, and requires immediate emergency care.
  • threshold – the brain’s susceptibility to having a seizure. Antiepileptic drugs raise this threshold and make a person less likely to have a seizure. In contrast, lack of sleep, fever, and other factors can lower the threshold and make seizures more likely.
  • vagus nerve stimulator (VNS) – a surgically implanted battery that sends bursts of electrical energy every few minutes to the vagus nerve. In some cases it has been effective in decreasing seizure activity.