Epilepsy: what is it?

Epilepsy is a neurological problem caused by electrical activity disorders in the brain. It manifests as attacks whose symptoms vary widely from one individual to another, ranging from violent seizures to loss of consciousness or hallucinations.

Epilepsy is a neurological problem caused by electrical activity disorders in the brain. It manifests as attacks whose symptoms vary widely from one individual to another, ranging from violent seizures to loss of consciousness or hallucinations.

Approximately one out of every 50 individuals experience unprovoked seizures over the course of their life. However, a single episode of unprovoked seizures does not mean an individual suffers from epilepsy. Generally, at least two episodes are required before epilepsy is diagnosed. The disorder is most commonly diagnosed in young children and individuals over the age of 65, but people of all ages can be affected.

While epilepsy cannot usually be cured, there are many effective ways to control it.

What causes epilepsy?

In about half of all cases, there is no identifiable cause for epilepsy. In the other half, one or more causes can be identified, including: - Head trauma - Other diseases: Meningitis, HIV, viral encephalitis, and even a heart attack or stroke, can produce brain lesions that cause epilepsy - Dementia is the leading cause of epilepsy in the elderly - Brain lesion in the fetus - Epilepsy is also sometimes associated with developmental disorders such as autism or Down syndrome - Genetic factors: Certain forms of epilepsy appear to be partly due to a genetic cause, since several family members can be affected

The symptoms of epilepsy

Epileptic seizures manifest in different ways, depending on the type of epilepsy. The symptoms are usually similar from one episode to the next, however, in a given individual.

Seizures are usually categorized as either partial or generalized:

- Simple partial seizures do not cause a loss of consciousness, but they can temporarily alter one’s emotions or senses, such as smell, sight or touch.

- Complex partial seizures temporarily disrupt the level of consciousness. These seizures often involve “unnecessary” movements such as hand-rubbing, swallowing, walking in circles or staring.

- Generalized seizures involve the whole brain. They include many sub-types ranging from “absence” (staring, subtle movement of the body) to violent convulsions.

Complications of epilepsy

An epileptic seizure can have serious consequences for you or your loved ones.

- Falling during a seizure can cause a head injury or a fracture.

- Epileptic individuals have a 13 percent greater risk of death by drowning than the general population, due to the risk of a seizure occurring while they are in water.

- A seizure while driving could have tragic consequences. This is why persons with epilepsy may have their driver’s license restricted until their condition is controlled.

- Seizures that occur during pregnancy can pose risks for both the mother and the baby. In addition, certain drugs used to treat epilepsy increase the risk of congenital malformations. However, most epileptic women can carry a healthy baby to term.

- Persons with epilepsy are more likely to suffer from psychological conditions such as depression and anxiety.

- In rare cases, status epilepticus can occur, which involves a seizure that lasts longer than five minutes, or seizures so frequent and close together that the individual does not regain consciousness between episodes.

- Lastly, persons with epilepsy have a greater risk of permanent brain lesions and death.

When is a medical visit in order? Family doctors are usually the ones first consulted for cases of epilepsy. Afterwards, an appointment with a neurologist may prove necessary. In order to come to the right diagnosis, the doctor may need to perform some tests to measure motor functions, behaviour and intellectual abilities, and blood tests and imaging exams in order to evaluate brain activity.

It is important to see a doctor when you have your first epileptic seizure. Prompt medical attention is also necessary if the seizure lasts more than five minutes, if breathing and consciousness do not return to normal after a seizure, if a second attack immediately follows the first, if the individual gets injured during the seizure, or if the seizure occurs when the person has a fever, suffers from heat exhaustion or is pregnant.

The treatment for epilepsy

Medications against epilepsy allow many individuals with the condition to no longer have seizures, or at least to reduce their frequency and intensity. It is estimated that half of all epileptic children are eventually able to discontinue the use of their medication and live without further seizures. After at least two years without a seizure, some adults may also stop their treatment.

It may take several trials before the right drug and the right dose are found for a given patient. Treatment usually begins with a single drug at a relatively low dose, which is then increased as needed until the seizures are well controlled. At least half of all newly diagnosed individuals get satisfactory results with the first drug they are prescribed.

Any medication can cause adverse effects. Drugs against epilepsy commonly cause somnolence, dizziness, rashes, and loss of coordination. Most of these effects abate after a few days or weeks. If an unpleasant adverse effect occurs, it must be mentioned to the doctor or pharmacist.

Many of the drugs used to control epilepsy can interact with other medications (prescription or over-the-counter), vitamin or mineral supplements, and natural products. It is very important to check with your pharmacist before taking any over-the-counter medication, supplement or natural product.

In children, some treatments involve dietary modifications. These diets do not suit every type of epilepsy. Before trying this approach, it is crucial that you obtain the doctor’s approval as well as support from a qualified nutritionist.

Lastly, adopting a healthy lifestyle – including stress management, limited alcohol intake, getting enough sleep and not smoking – can help control epilepsy. It is also strongly recommended that epileptic individuals wear a bracelet stating their condition in order to help emergency services in case of a seizure.

What to do if you witness an epileptic seizure?

- Call emergency services. - Protect the person’s head. - Remove any potentially dangerous objects. - Time the duration of the seizure. - Do not put any object in the person’s mouth. - Once the seizure has passed, gently turn the person onto his or her side and provide reassurance until the medical personnel arrives.