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What Patients and their Doctors Need to Know About Epilepsy

Epilepsy is another term for “seizure disorders.” Seizures are caused by disruption of electronic communications between neurons. One in 26 people in the U.S. will develop epilepsy at some point in their lives. It is not contagious, is not a psychiatric illness and is not a developmental disability.

Most people with epilepsy can do the same things that people without epilepsy can do. However, some people with frequent seizures may not be able to work or drive, or may have problems in other parts of life.

Six out of 10 people have an epilepsy of unknown cause. When a cause is found, it is often due to head injury, a brain infection, stroke, brain tumor, Alzheimer’s disease, malformation of an area of the brain, and/or genetic factors.

Epilepsy is diagnosed after at least two seizures that are not caused by a known medical condition. It is usually diagnosed with a medical history, neurological examination, blood work, electroencephalograph (EEG), and/or CT, MRI, or PET scans of brain.

Common types of seizures include:

Generalized Onset - Tonic-Clonic (Grand Mal) consists of convulsions, rigid muscles, and jerking, and typically lasts one to three minutes followed by period of confusion.

Generalized Onset - Absence (Petit Mal) results in a blank stare lasting only a few seconds, sometimes with blinking or chewing motions.

Focal Onset - Impaired Awareness (Complex Partial) starts with staring and a dazed facial expression; the person is not aware of what is going on or will not remember; the person may perform repetitive random movements and may not be able to talk normally. This typically lasts one or two minutes and may be followed by confusion.

Focal Onset - Aware (Simple Partial) causes jerking in one or more parts of the body, or sensory or perceptual changes that may or may not be obvious to onlookers; the person is aware of what is occurring during the seizure.

Atonic (Drop Attacks) are less common compared to other seizure types. There is a sudden collapse with recovery within a minute.

Myoclonic consists of sudden, brief, massive jerks involving all or part of the body.

Epilepsy

To help someone who is having a seizure, first aid is simple: Stay. Safe. Side.

  • Stay with the person until they are alert and awake after the seizure.
  • Safe: Move or guide them away from harm.
  • Side: Turn the person on their side if they are not alert or awake during the seizure, and keep their airway clear. Do not restrain or put any objects in their mouth.

Remain calm and time the seizure. Call 911 if it’s the first seizure, if there are repeated seizures, if the seizure lasts for more than five minutes, if the person is pregnant/injured/sick, if they do not return to their usual state of health, if they are having difficulty breathing, or if the seizure occurs in water.

Epilepsy is treated with anti-seizure medications. At times, depending on type of seizures, surgery, Vagus Nerve Stimulation (VNS), responsive neurostimulation (RNS), deep brain stimulation (DBS), and dietary therapies, like ketogenic diets, may be used.

Seizure freedom, if possible, is the goal of therapy. Our team at UTMB Health has expertise in seizure disorders and can recommend the best treatment plan to help patients manage their epilepsy and enjoy an improved quality of life.

Source: The Epilepsy Foundation 


Kamakshi Patel, MD, MPH

Kamakshi Patel, MD, MPH, is a Clinical Associate Professor in the Department of Neurology. She is Director of the Clear Lake Campus Neurology Clinics and the Neurology Residency Program.

Epilepsy care at UTMB Health