Epilepsy

Epilepsy is a brain disorder characterized by repeated seizures, which are periods of sudden abnormal electrical brain activity. There are many kinds of seizures, ranging from short staring spells (an "absence seizure") to loss of consciousness with uncontrollable movements of the arms and legs ("tonic-clonic" seizures).

While seizures can be unsettling to experience, epilepsy is actually one of the most common brain disorders and is quite treatable. Sixty to 70% of those diagnosed with epilepsy become seizure-free with treatment. 1

What are the symptoms of epilepsy?

Repeated seizures are the primary symptom of epilepsy. There are two basic kinds of seizure, generalized and focal, which are differentiated by where in the brain the seizure activity is. Each of these groups is further divided into types of symptoms caused by the seizures. Most people with epilepsy experience the same set of symptoms with each seizure.

Focal Seizures

Just as the group names imply, focal seizures occur because of abnormal brain activity on one area of the brain. The most common types of focal seizures include those with impaired awareness and loss of consciousness.

  • Focal seizures with impaired awareness: These seizures cause repetitive motions or unfocused behavior, where the patient seems awake but does not respond to what is going on around them.
  • Focal seizures without loss of consciousness: These seizures are experienced as a sudden change in physical or emotional condition. They may manifest as twitching or tingling in a limb, mood swings, nausea, or changes in sensation.

Generalized Seizures

Generalized seizures involve activity across the entire brain. They include a range of subtypes classified by what the patient's muscles are doing during the episode.

  • Absence/petit mal seizures: Petit mal seizures, are very short (5-10 second) episodes of loss of awareness and staring into space but no change in muscle movement or control.
  • Tonic-clonic/ grand mal seizures: These include sudden loss of consciousness, full body stiffening, and twitching and/or shaking, which can last for several minutes.

Other possible presentations of generalized seizures include: a sudden loss of muscle tone causing collapse, stiffening of muscles coupled with loss of consciousness, or jerking rhythmic muscle movements.

What causes epilepsy?

It is not always clear what causes a person to develop epilepsy. When a cause is found, it is a condition or event which has changed the structure of the brain, such as a severe case of meningitis or traumatic injury. Some other examples include:

  • Brain tumors
  • Stroke
  • Autism
  • Viral encephalitis

Some people have a higher risk of epilepsy. Individuals with a family history of epilepsy, children, the elderly, individuals with dementia, and individuals with blood vessel diseases are more likely to experience epilepsy.

How is epilepsy diagnosed and treated?

Diagnosis

At least two seizures without an immediate cause (such as a high fever) more than 24 hours apart are required to diagnose epilepsy. You should report all seizures to your doctor in as much detail as possible. Your doctor will reach a diagnosis based on this report of your symptoms along with in-office physical and neurological examinations, and your medical history.

Your doctor may also order a variety of mostly non-invasive tests to determine the cause of your epilepsy, including:

  • Blood tests
  • Electroencephalogram (EEG), a test where sensors are placed on the patient's head to detect brain acitivty. EEGs sometimes show where in the brain a seizure begins.
  • Imaging tests such as CT scans and MRIs
  • Neuropsychological testing, a set of activities to test memory and other brain functions and involves no machines.

Treatment

  • Anti-seizure medication. In most cases, epilepsy is effectively treated with anti-seizure medication. There are dozens of anti-seizure medications; your doctor may prescribe one or more based on the kinds of seizures you have and may switch medications if the first one prescribed is not as effective as they hoped or causes problematic side effects.
  • Surgery. In cases where there no appropriate medication can reduce or eliminate seizures, sometimes surgery to remove the tissue causing your seizures is an option.
  • Medical Devices. Even more rare potential approaches include implantable devices, similar to pacemakers, applied to specific cranial nerves or parts of the brain. Additionally, particularly in childhood cases, your doctor may prescribe short-term changes to your diet.

Why Choose NGPG?

NGPG Neuroscience employs several board-certified neurologists, neurosurgeons, neurointerventional surgeons, neuropsychiatrists, and other specialists who provide high-quality care and up-to-date treatments through our two outpatient Neurology office locations. For imaging and surgical care, we partner with the Northeast Georgia Medical Center’s expert neurosciences team and state-of-the-art facilities, ensuring our patients’ access to all of the services of a leading hospital alongside our excellent outpatient care.

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  1. Source: 2015, Neligan, A; Sander, J. W. "The Prognosis of Epilepsy" accessed at https://epilepsysociety.org.uk/sites/default/files/2020-08/Chapter36Neligan2015.pdf