Seizure disorder; Epileptic - epilepsy
Epilepsy is a brain disorder in which a person has repeated seizures over time. Seizures are episodes of uncontrolled and abnormal firing of brain cells that may cause changes in attention or behavior such as bodily movements.
Epilepsy occurs when changes in the brain cause it to be too excitable or irritable. As a result, the brain sends out abnormal signals. This leads to repeated, unpredictable seizures. (A single seizure that does not happen again is not epilepsy.)
Epilepsy may be due to a medical condition or injury that affects the brain. Or, the cause may be unknown (idiopathic).
Common causes of epilepsy include:
Epileptic seizures can happen to anyone at any age. However, they're more common in young children and people age 65 years and older. There may be a family history of seizures or epilepsy.
Symptoms vary from person to person. Some people may have simple staring spells. Others have violent shaking and loss of alertness (convulsion). The type of seizure depends on the part of the brain that is affected.
Most of the time, the seizure is similar to the one before it. Some people with epilepsy have a strange sensation before each seizure. Sensations may be tingling, smelling an odor that is not actually there, or emotional changes. This is called an aura.
Your health care provider can tell you more about the specific type of seizure you may have:
Your provider will perform a physical exam. This will include a detailed look at brain and nervous system function.
An electroencephalogram (EEG) will be done to check the electrical activity in the brain. People with epilepsy often have abnormal electrical activity seen on this test. In some cases, the test shows the area in the brain where the seizures start. The brain's electrical activity may appear normal after a seizure or between seizures.
To diagnose epilepsy or plan for epilepsy surgery, you may need to:
Tests that may be done include:
Treatment for epilepsy includes taking medicines, lifestyle changes, and sometimes surgery.
If epilepsy is due to a tumor, abnormal blood vessels, or bleeding in the brain, surgery to treat these disorders may make the seizures stop.
Medicines to prevent seizures, called anticonvulsants (or antiepileptic medicines), may reduce the number of future seizures:
Many epilepsy medicines may affect the health of your bones. Talk to your provider about whether you need vitamins and other supplements.
Epilepsy that does not get better after 2 or 3 anti-seizure medicines have been tried is called "medically refractory epilepsy." In this case, your provider may recommend surgery to:
Some children are placed on a special diet to help prevent seizures. The most popular one is the ketogenic diet. A diet low in carbohydrates, such as the Atkins diet, may also be helpful in some adults. Be sure to discuss these options with your provider before trying them.
The stress of having epilepsy or being a caretaker of someone with epilepsy can often be helped by joining a support group. In these groups, members share common experiences and problems.
Some people with epilepsy may be able to reduce or even stop their anti-seizure medicines after having no seizures for several years. Certain types of childhood epilepsy go away or improve with age, usually in the late teens or 20s.
For many people, epilepsy is a lifelong condition. In these cases, anti-seizure drugs need to be continued. There is a very low risk for sudden death with epilepsy.
Complications may include:
Call 911 or the local emergency number if:
In the case of someone who has had seizures before, call 911 or the local emergency number for any of these emergency situations:
Call your provider if any new symptoms occur:
There is no known way to prevent epilepsy. Proper diet and sleep, and staying away from alcohol and illegal drugs may decrease the likelihood of triggering seizures in people with epilepsy.
Reduce the risk for head injury by wearing a helmet during risky activities. This can lessen the likelihood of a brain injury that leads to seizures and epilepsy.
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Epilepsy Foundation website. Facts & statistics about epilepsy. www.epilepsy.com/what-is-epilepsy/statistics. Updated February 27, 2019. Accessed June 21, 2023.
Epilepsy Foundation website. Who can get epilepsy? www.epilepsy.com/what-is-epilepsy/understanding-seizures/who-gets-epilepsy#When-are-people-most-likely-to-get-epilepsy?. Updated February 4, 2022. Accessed June 21, 2023.
González HFJ, Yengo-Kahn A, Englot DJ. Vagus nerve stimulation for the treatment of epilepsy. Neurosurg Clin N Am. 2019;30(2):219-230. PMID: 30898273 pubmed.ncbi.nlm.nih.gov/30898273/.
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Wiebe S. The epilepsies. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 375.BACK TO TOP
Review Date: 4/29/2023
Reviewed By: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School of Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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