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Epilepsy FAQs

1. What is epilepsy?

Epilepsy is a general term that refers to a tendency to have recurrent seizures. A seizure is a temporary disturbance in brain function in which groups of nerve cells in the brain signal abnormally, usually excessively. Nerve cells or neurons normally produce electrical impulses that act on other nerve cells, muscles, or glands to create awareness, thought, sensations, actions, and control of internal body functions. During a seizure, disturbances of normal nerve cell activity produce symptoms that vary depending on which part and how much of the brain is affected. Seizures may produce changes in awareness or sensation, involuntary movements, or other changes in behavior. Usually, a seizure lasts from a few seconds to a few minutes.

2. What are seizures?

There are many types of seizures, but they can be classified into two broad groups:

  • Primary generalized seizures: Seizures begin with widespread involvement of both sides of the brain
  • Partial seizures: Seizures begin with involvement of a smaller, localized area of the brain. With some partial seizures, the disturbance can still spread within seconds or minutes to involve widespread areas of the brain causing a secondary generalized seizure.

Some people have seizures that are hardly noticeable to others. Sometimes, the only clue that someone is having an absence seizure (a seizure that causes a lapse in awareness) is rapid blinking or a few seconds of staring into space. In contrast, someone having a complex partial seizure (brief seizures that may last less than 15 seconds) may appear confused or dazed and will not be able to respond to questions or direction for up to a few minutes. Someone having a generalized tonic-clonic seizure (a stronger, more visible type of seizure that may last one to three minutes and take longer for a person to recover) may cry out, lose consciousness, fall to the ground and have rigidity and muscle jerks lasting several minutes, with an extended period of confusion and fatigue afterward.

3. Is having a seizure the same as having epilepsy?

Not necessarily. In general, seizures do not indicate epilepsy if they only occur as a result of a temporary medical condition such as a high fever, low blood sugar, alcohol or drug withdrawal, or immediately following a brain concussion. Among people who experience a seizure under such circumstances, without a history of seizures at other times, there is usually no need for ongoing treatment for epilepsy, only a need to treat the underlying medical condition.

4. How many people have epilepsy in the United States?

Based on recent surveys, the CDC estimates that nearly 2.5 million people in the United States have epilepsy. A more conservative estimate suggests that about 2.1 million people currently have epilepsy, with 150,000 developing the condition each year. New cases of epilepsy are most common among children and older adults.

5. What causes epilepsy?

Epilepsy may arise when there are disruptions to the normal connections between nerve cells in the brain. Much like disruptions in wiring of complex electrical circuit, imbalances of natural chemicals or neurotransmitters or changes in the membranes of nerve cells alter these connections, causing seizures. Some of these disruptions, imbalances and changes may develop early in life, related to hereditary factors or early exposures and events. Others may be acquired later. Known conditions and events that may lead to epilepsy include:

  • Oxygen deprivation, usually during childbirth
  • Brain abcess or brain infections such as meningitis, encephalitis and cysticercosis
  • Traumatic brain injury or head injury.
  • Stroke, resulting from a block or rupture of a blood vessel in the brain
  • Other neurologic diseases such as Alzheimer disease
  • Brain tumors
  • Certain genetic disorders

In nearly two-thirds of the cases of epilepsy, a specific underlying cause cannot be identified, and the focus remains on developing the most effective treatment.

6. Can epilepsy be prevented?

Sometimes epilepsy may be preventable. Some of the most important opportunities for prevention are:

  • Complications of pregnancy and childbirth: Proper prenatal care to avoid problems during pregnancy and childbirth may lessen complications that could lead to epilepsy.
  • Infections: Proper immunization (vaccination) against certain diseases of childhood and adolescence or young adulthood may lessen the likelihood of infections that may sometimes involve the central nervous system and lead to epilepsy.
  • Traumatic brain injuries: Brain injuries, often due to motor vehicle crashes or falls, are a frequent cause of epilepsy. Consistently using safety belts and safety seats for small children, airbags, bicycle helmets and motorcycle helmets helps reduce the occurrence and severity of motor vehicle and traffic injuries. While older adults have an increased risk of brain injuries due to falls, there are effective measures to reduce this risk as well.
  • Stroke: Reducing or treating risk factors such as physical inactivity, high blood pressure, obesity, diabetes, high cholesterol and smoking will lessen the likelihood of a stroke and heart disease, which may help to reduce the possibility of developing epilepsy later in life.

7. How is epilepsy treated?

Before you begin treatment, the first step is to ensure that the diagnosis of epilepsy is correct and to determine, if possible, the type of epilepsy and whether there are any underlying conditions that also need treatment. This will require a careful review of your medical history and a neurological examination along with any other recommended tests. The plan of care for treating your epilepsy is based on this evaluation, and it may include:

  • Medication. Antiepileptic drugs are the mainstay of treatment for most people. There are now many drugs available, and the doctor may recommend one or more of these based on your individual factors such as the type of epilepsy, the frequency and severity of the seizures, age and related health conditions. Close monitoring will be required at first to assess the effectiveness of the drug and possible side effects. Early in treatment, dosage adjustments are often required, and it may be necessary to change to a different, more effective drug. For about two-thirds of people with epilepsy receiving optimum treatment, drugs are successful in fully controlling seizures. For the remainder, other treatment options may be considered.
  • Surgery. With certain types of partial epilepsy, especially when it can be determined that seizures consistently arise from a single area of the brain called the seizure focus, surgery to remove that focus may be effective in stopping future seizures or making them much easier to control with medication.
  • Other options. Other supplemental treatments and procedures are sometimes beneficial when medications alone are inadequate and surgery is not possible. Your doctor will explain these options with you if they become necessary.

8. Who treats epilepsy?

Doctors from several medical specialties may treat people with epilepsy. Primary care doctors such as family physicians, pediatricians and internists are often the first doctors to see a patient with new seizures. They may make the initial diagnosis of epilepsy or they may consult with a neurologist, a specialist in the brain and nervous system, to confirm the diagnosis and recommend treatment. Primary care doctors sometimes provide follow-up care for patients with epilepsy, but when problems arise such as medication side effects or recurring seizures, you may be referred to a neurologist or pediatric neurologist for consultation or continuing care.

Some neurologists with advanced training specialize in the diagnosing and treating epilepsy. People whose seizures are difficult to control or who need specialized or intensive care for epilepsy may be referred to specialized epilepsy centers, which have advanced diagnostic and treatment capabilities and are staffed by physicians, neurosurgeons, psychologists, nurses and technicians specializing in epilepsy care.

9. What issues are unique for women with epilepsy?

Women with epilepsy can experience difficulties arising from hormonal changes during their reproductive cycle that sometimes can affect the tendency to have seizures. Pregnancy brings special considerations for women with epilepsy, because seizure occurrence and certain drugs taken during this time may sometimes carry a risk of harm to the developing fetus. Usually these risks can be minimized by several precautions women can take before and during pregnancy.

10. Can epilepsy be fatal?

Most people with epilepsy live a full life span. Nevertheless, the risk of premature death is increased for some, depending on several factors:

  • Sometimes epilepsy is a symptom of a more serious underlying condition such as a stroke or a tumor that carries an increased risk of death.
  • People with some types of epilepsy who continue to have major seizures can experience injuries during a seizure from falling or hurting their head that may occasionally be life-threatening.
  • Very prolonged seizures or seizures in rapid succession, a condition called status epilepticus, can also be life-threatening. Status epilepticus can sometimes occur when seizure medication use is stopped suddenly.
  • Rarely, people with epilepsy can experience sudden death. These events are not well understood, although they are suspected sometimes to be due to heart rhythm disturbances during a seizure. The risk of sudden death is not increased for all types of epilepsy, but occurs more among people with major seizures that are not well controlled. Optimal seizure control and some common-sense safety measures can reduce the risk of epilepsy-related mortality.

Source: Centers for Disease Control