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Epilepsy

Dr Roger Henderson
Reviewed by Roger HendersonReviewed on 29.04.2024 | 5 minutes read
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Epilepsy is a condition that affects the brain and causes seizures. These seizures happen because of abnormal electrical activity in the brain. Epilepsy affects lots of people all over the world and can have a big impact on their lives. It doesn't just affect the person who has epilepsy, but also their families, friends, and the wider community. Living with epilepsy can be tough.

People with epilepsy can have problems with their memory, mood, and daily activities. They might also have a hard time with school, work, and social activities. It's important to learn about epilepsy so you can understand what it is and how it affects people. It can also help people with epilepsy to feel more supported and valued. If you or someone you know has epilepsy, it's important to seek help from your doctor.

There are treatments available that can help manage seizures and improve quality of life. Remember, you are not alone. With the right support, you can live a happy and fulfilling life, no matter what challenges you may face.

Types of Seizures

In epilepsy, seizures happen when the brain sends abnormal electrical signals. There are different types of seizures, such as:

  • Focal seizures that start in one area of the brain
  • Generalised seizures that affect both sides of the brain

Focal seizures can be either:

  • simple - where the person remains aware of their surroundings

  • complex - where they may lose consciousness and have involuntary movements

There are different types of generalised seizures and each has its own unique symptoms. They are:

  1. Tonic-clonic seizures: sudden onset of muscle contractions, loss of consciousness, and often convulsions.
  2. Absence seizures: brief episodes of staring off into space, blank facial expression, and a brief loss of awareness.
  3. Myoclonic seizures: rapid and brief muscle jerks, usually affecting the arms and legs.
  4. Atonic seizures: sudden loss of muscle tone, causing the person to collapse or fall.
  5. Tonic seizures: sudden muscle contractions, causing the person to fall to the ground or lose balance.

Symptoms of epilepsy can vary, from changes in senses or perception before a seizure to a loss of consciousness, as well as muscle movements, altered sensations, cognitive changes, and autonomic symptoms. Some people may have epilepsy syndromes that cause “clusters” of seizures with specific symptoms, triggers, age of onset, and prognosis.

Causes and Risk Factors of Epilepsy

Genetic factors play a significant role in epilepsy, and having a family history of the condition increases the risk due to specific genetic mutations. Other things that increase risk are:

  • Brain injuries
  • Infections affecting the central nervous system
  • Prenatal and perinatal factors
  • Developmental disorders
  • Seizure triggers such as sleep deprivation or stress

How is Epilepsy Diagnosed?

When it comes to diagnosing epilepsy, a thorough evaluation is necessary. This includes a detailed medical history, physical examination, and various tests like an electroencephalogram (EEG), imaging studies, and blood tests. An EEG is helpful in detecting abnormal electrical activity in the brain, while imaging tests such as an MRI or CT scan help identify structural abnormalities.

In some cases, video EEG monitoring may be required to capture and characterise seizures more accurately. This comprehensive approach helps confirm the diagnosis, identify seizure types, determine potential causes, and guide treatment decisions.

How is Epilepsy Treated?

Anti-seizure medications are drugs that help control seizures and reduce their frequency and intensity. There are many different types of these medications available, each with their own set of benefits and potential side effects.

Here are some common examples of anti-seizure medications:

  1. Carbamazepine (brand name Tegretol)
  2. Valproic acid (brand name Depakote)
  3. Lamotrigine (brand name Lamictal)
  4. Phenytoin (brand name Epanutin)
  5. Topiramate (brand name Topamax)
  6. Gabapentin (brand name Neurontin)
  7. Levetiracetam (brand name Keppra)
  8. Oxcarbazepine (brand name Trileptal)

It's important to note that the specific medication or combination of medications recommended for an individual with epilepsy will depend on many factors, including the type of seizures they experience, their overall health, and any other medications they may be taking.

Other treatment options include:

  • ketogenic diet

  • vagus nerve stimulation (VNS)

  • surgical interventions to remove or disconnect the epileptic focus

  • lifestyle modifications such as adequate sleep and stress management

Living with Epilepsy

Living with epilepsy can present various challenges, but with proper management and support, individuals can lead fulfilling lives. Epilepsy can be managed through medication, safety precautions, response plans, diaries, and emotional support from healthcare professionals or support groups.

Remember, you're not alone, and there are resources available to help you navigate the challenges of living with epilepsy.

Alternative Therapies

In addition to traditional treatments, some people with epilepsy may consider alternative or complementary therapies such as acupuncture, herbal remedies, mindfulness and meditation, and dietary changes. These approaches may not replace traditional treatments, but they can help support overall well-being and complement existing therapies.

Services for People with Epilepsy

These include the Epilepsy Action and other local UK support groups, seizure response dogs, educational and vocational services, and legal and advocacy resources. These resources can help people manage their condition effectively and improve their quality of life.

Researchers are working hard to find new and innovative ways to treat epilepsy. Some of the areas they are exploring include:

  • precision medicine

  • neurostimulation therapies

  • gene therapy

  • cannabinoids

  • medical cannabis

  • brain imaging

  • biomarkers

By improving our understanding of epilepsy and developing new treatments, scientists hope to help people living with the condition better control seizures and improve their quality of life.

It is important for individuals with epilepsy to feel empowered, as this enables them to take control of their condition, speak up for their needs, and live fulfilling lives. Efforts to advocate for people with epilepsy aim to increase awareness, decrease stigma, promote access to resources and support, and encourage positive changes in laws and policies. By educating themselves, speaking up for themselves, engaging with peers and the community, and participating in research initiatives, individuals with epilepsy can take meaningful steps towards improving their own well-being and the lives of others in the epilepsy community.

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Dr Roger Henderson
Reviewed by Roger Henderson
Reviewed on 29.04.2024
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