What is Epilepsy?

When most people think of epilepsy, what comes to mind is an individual who stiffens up, falls to the ground and shakes uncontrollably for a period of time. The classic tonic-clonic, or grand mal, seizure does of course exist. But there are a number of other types of seizures, from absence (what used to be called petit mal) seizures, to myoclonic jerks, to simple and complex partial seizures.

Epilepsy, otherwise known as seizure disorder, is a common neurological condition. It affects about 0.6 percent of Canadians, 0.7 percent of people in the UK, and just under 1 percent of Americans. In all, there are over forty different types of epilepsy. Each has its own unique characteristics, and each is helped by differing types of treatments.

What Causes Epileptic Seizures?

Seizures are abnormal bursts of electricity in the brain, due either to a malformation or injury of the brain itself, to some condition which interferes with the normal functioning of neurotransmitters, or to a combination of both. Because each part of the brain controls different functions and sensations, seizures differ in large part according to where they start.

A common part of diagnosis is neurological testing. This most often includes an electroencephalogram (EEG) and brain scans such as computed axial tomography (CAT) and magnetic resonance imaging (MRI.) These tests and others allow doctors to detect where seizures begin in the brain, to detect some possible triggers (flashing lights, hyperventilating,) and sometimes to evaluate whether the person is a candidate for surgery.

Controlling Seizures

Once an individual is diagnosed as having epilepsy, they are usually prescribed an anticonvulsant medication. If the person has more than one type of seizure, or if the seizures are not well controlled with one medication, two or more drugs may be used together.

It is important that the person takes the correct dose of medication each day, at the prescribed time and in the prescribed manner. The doctor will usually explain this, but the pharmacist is also an important resource person. They should be consulted about any over the counter medications, vitamins, or herbal supplements.

All doctors the person sees should be aware of their epilepsy and the drugs they take. Some drugs can increase unwanted side effects like dizziness and sleepiness, while others may lessen the effectiveness of the anticonvulsant. Even everyday foods like grapefruit can interfere with the action of the medication, and are to be avoided.

Other strategies to control seizures may include surgery (usually for those not well controlled with medication,) avoidance of known triggers (fatigue, stress, alcohol or flashing lights, etc.,) keeping a seizure diary to help determine patterns or pinpoint triggers, and the use of a service dog trained to warn the individual when a seizure is about to occur. While the animal cannot prevent a seizure from happening, it can allow the person to get to a safe place before the seizure occurs, and provides companionship during the post-ictal phase, when the individual may be disorientated or in some pain.

In recent years electrical interventions like the vagus nerve stimulator (VNS,) responsive neurostimulator system (RNS,) and deep brain stimulation (DBS) have shown promise as well. These involve implanted devices similar to a pacemaker or a cochlear implant, which use electrodes to stimulate the brain or other parts of the nervous system. These are options for an individual poorly controlled with drugs, but who is hesitant to have a more invasive brain surgery or for whom the focus (the place where seizures originate) cannot be determined precisely enough for surgery.

Disclaimer: The writer of this article is not a doctor. Data presented is gathered from research and personal experience, and is intended for information purposes only. Individuals with epilepsy, or parents who suspect their child might have photosensitive epilepsy, should seek advice from a neurologist or other competent medical practitioner.

Sources:

"Epidemiology" Epilepsy Canada

"Epilepsy" Wikipedia

"Epilepsy: Seizures" NHS (National Health Services) Choices

"NINDS Epilepsy Information Page" National Institute of Neurological Disorders and Stroke (NIH)

"What is Epilepsy?" Epilepsy Foundation