Epilepsy, which is sometimes called a seizure disorder, is a disorder of the brain. A person is diagnosed with epilepsy when they have had two or more seizures (Centers for Disease Control and Prevention, Epilepsy Basics, April 11, 2017).
Normal brain function is made possible by millions of tiny electrical charges passing between nerve cells in the brain and to all parts of the body. When someone has epilepsy, this normal pattern may be interrupted by intermittent bursts of electrical energy that are much more intense than usual. They may affect a person's consciousness, bodily movements or sensations for a short time.
Types of Seizures
These physical changes are called epileptic seizures. That is why epilepsy is sometimes called a seizure disorder.
There are two groups of seizures:
- General seizures affect both sizes of brain and may affect nerve cells throughout the brain.
- Focal seizures, also called partial seizures, are in one area of the brain.
Normal brain function cannot return until the electrical bursts subside. Conditions in the brain that produce these episodes may have been present since birth, or they may develop later in life due to injury, infections, structural abnormalities in the brain, exposure to toxic agents, or for reasons that are still not well understood.
Types of Seizure Syndromes
Seizure syndromes are classified as a cluster of features which includes the age when seizures begin, the seizure types, and EEG findings, along with other features. Click here for additional information about seizure syndromes.
If you have had two or more seizures that started in the brain you may be diagnosed with epilepsy. Getting a diagnosis is not always easy as there is no single test that can diagnose epilepsy.
Unfortunately, there is no cure for epilepsy. The goal for epilepsy patients is to reduce the rate of seizure occurrence and side effects from prescribed medication. While seizure medication is the most common form of treatment, there are other approaches for controlling seizures it is recommended that you seek specialized care. Epilepsy specialist can assist you in exploring a plethora of new and innovative treatment plans such as adding on new medication, surgery, devices, dietary therapy, or a clinical trial.
Seizure First Aid and Safety
- All seizures are different, awareness and consciousness differ from person to person however, the goal is to provide general care and comfort to keep the person safe.
- Always stay with the person until the seizure is over.
- Note the time the of the seizure from beginning to end.
- Stay calm, talk calm and reassuringly to the person having the seizure and those around you.
- Make the person as comfortable as possible.
- Keep additional people “onlookers” to a minimum.
- Do not forcibly hold a person down.
- Do not put anything in the person’s mouth.
- Make sure their breathing is normal.
- Do not give the person anything to eat, drink, or swallow unless they are fully aware and conscious.
- Call for emergency medical help when:
- A seizure lasts five minutes or longer.
- One seizure occurs right after another without the person regaining consciousness or coming to between seizures.
- Seizures occur closer together than usual for that person.
- Breathing becomes difficult or the person appears to be choking.
- The seizure occurs in water.
- Injury may have occurred.
- The person asks for medical help.
- Be sensitive and supportive and ask others to do the same.
Early Death and SUDEP
For many people, epilepsy is a condition which can be well-managed and has little or no impact on their life. For others, ongoing seizures mean that epilepsy has a long-term impact on them and their ability to have a ‘normal life’. Like some other medical conditions, epilepsy can be a cause of death in some individuals, although this is not common.
The sudden, unexpected, witnessed or unwitnessed, non-traumatic, and non-drowning death in patients with epilepsy with or without evidence for a seizure, and excluding documented status epilepticus, in which postmortem examination does not reveal a structural or toxicological cause for death. Meaning- SUDEP is when someone is believed to have died during or after a seizure where no other cause of death can be found.
Reducing the Risk
As SUDEP is thought to be linked to seizures happening, getting the best seizure control possible is a positive way to reduce risks, including the risk of accident, injury and SUDEP.
Getting the best seizure control possible might include:
- Take anti-epileptic drugs (AEDs) consistently (every day) and around the same time or times each day.
- This is sometimes referred to as ‘being adherent’ to medication. If you have difficulties taking your medication (for example, if you find it difficult to remember to take your medication), aids such as pill boxes (drug wallets) might be helpful.
- Keep a diary of when your seizures happen.
- This will help to show if there is a pattern to your seizures and whether any situations trigger your seizures (like being tired or stressed). It might also be useful to see how well medication is working to control your seizures.
- If you are still having seizures, having a review of your epilepsy and treatment with a neurologist or epilepsy nurse might be helpful. There may be changes to your treatment that would help to reduce the number of seizures you have.