What are epilepsy symptoms?

What causes epilepsy?

Some types of epilepsy are inherited, others are caused by brain injuries, and still more have an unknown cause. Up to 60% of people with epilepsy fall into the unknown category.

A person who has one seizure that cannot be explained by a medical problem has about a 25% chance of having another seizure. A second seizure occurrence indicates a roughly 70% chance of future seizures, and a diagnosis of epilepsy.

Who is most at risk of developing epilepsy?

Epilepsy is most common in young children and older adults, but the condition can affect people at any age. Epilepsy is slightly more common in males than females.

While genetics or trauma may cause some types of epilepsy, other risks factors for developing epilepsy are relatively unknown. However, many people with epilepsy are able to identify triggers that can lead to epileptic seizures.

What are triggers of epilepsy?

A trigger is anything that provokes another action. For people with epilepsy, a trigger is something that leads to a seizure. Some patients are able to identify patterns in their seizures, which helps them pinpoint and avoid triggers that lead to their epileptic seizures. Certain triggers that have been associated with epilepsy include:

• Caffeine
• Alcohol
• Fatigue
• Stress
• Illness
• Certain drug or medication use
• Abnormal eating, like skipping meals or overeating
• Certain food ingredients

Keeping a seizure journal may help you identify different triggers. Many patients have a combination of triggers that lead to a seizure. The best way to pinpoint triggers that may be causing your seizures is to keep a detailed journal. The journal should be as specific as possible, noting exactly what you ate and drank, time of day you ate, how much you slept, various activities, etc. The Epilepsy Foundation offers more information on how you can track your daily habits and seizure activity.

How is epilepsy diagnosed?

Epilepsy is often diagnosed after a visit to the emergency room for a seizure. The most important tool for diagnosing epilepsy is an electroencephalogram (EEG), ideally performed within 24 hours of a suspected seizure. EEG is a noninvasive test that evaluates the electrical activity in the brain. EEG tests can last from under an hour to an entire day, or even longer for patients who do not respond to medications. Multiple tests may be needed, particularly for some types of partial seizures, which can show up as normal on an EEG.

First-time seizures are frequently tested with computerized tomography (CT). Your doctor may decide to do a CT in addition to another test, which could include magnetic resonance imaging (MRI) or positron emission tomography (PET). Often these extra tests are done when other tests do not produce quality results. The course of treatment will vary depending on the type of seizure and how often they occur.

What is an epilepsy monitoring unit?

Neurosurgery One neurosurgeons who specialize in treating epilepsy in adults are part of the epilepsy team at Littleton Adventist Hospital and utilize the hospital’s Epilepsy Monitoring Unit (EMU) to accurately diagnose and develop treatment plans for patients with epilepsy.

Littleton Hospital’s EMU is designed for patients 17 and older who need prolonged inpatient video electroen­cephalogram (EEG) monitoring. The EMU provides the medical team the ability to safely provoke seizure activity by removing anti-epileptic drugs in a controlled environment. The EMU is physically located within the hospital’s intensive care unit, so that the nursing staff can closely monitor patients and immediately access acute care when seizures occur to keep patients safe. Our epilepsy team provides a definitive diagnosis in 88% of cases and we use EMU evaluations in our treatment decisions for 8 out of 10 patients. Learn more about the Epilepsy Monitoring Unit at Littleton Adventist Hospital. 

What are the different types of seizures?

Experts have identified two main types of seizures:

• Partial seizures are more common than generalized seizures and occur in one or more areas of the brain. Partial seizures are likely to develop from a specific cause or injury but can develop for no known reason. Partial seizures are organized into two categories – simple and complex. If you experience a simple partial seizure, you won’t lose consciousness, and your seizure will typically last about 90 seconds. If you experience a complex partial seizure, you may lose consciousness briefly, but the episode typically lasts no more than two minutes. A little more than half of adult seizures are complex partial.
• Generalized seizures take place over a larger area of the brain, which leads to more serious effects for the person having a seizure. Generalized seizures are organized into two main categories – grand mal and petit mal. If you experience a grand mal seizure, you will most likely lose consciousness without warning, with the entire episode lasting  2-3 minutes. If you have a petit mal seizure, you may lose consciousness briefly for 3-30 seconds or you may not even realize what is happening. A person may experience as many as 50-100 petit mal seizures in a day.

How is epilepsy treated?

Anti-epileptic drugs (AEDs) are the standard first line of treatment for epilepsy patients. AEDs are used for patients who have had two or three seizures, or after a single seizure if tests show that the person is at risk for another seizure. If your seizures are not adequately controlled with one medication, your neurologist may recommend additional medicines or change medications.

In about 40% of patients, drugs will not control epilepsy symptoms. If you are not getting the symptom control you would like with medication, you may want to consider epilepsy surgery. Epilepsy surgery has advanced, with new minimally invasive procedures now available. Neurosurgery One offers five types of epilepsy surgery:

• Laser Interstitial Thermal Therapy (LITT), also called ablation
• NeuroPace, also called responsive neural stimulation
• Vagus nerve stimulation (VNS)
• Deep brain stimulation (Neurosurgery One performs Robotic-Guided Asleep Deep Brain Stimulation in addition to traditional DBS)
• Resection

Can I treat epilepsy at home?

You may be able to identify specific triggers for your seizures and modify your lifestyle or diet to reduce the occurrence or intensity of of your seizures. However, most epilepsy patients benefit from medications or surgery, which provide more seizure control. You should carefully consider all options as you work closely with your neurologist to manage your epilepsy.

Is there a cure for epilepsy?

Epilepsy cannot be cured, but it can be controlled with medications or surgery. If you have tried two or more anti-epileptic drugs (AEDs) and are not getting the control you desire or you don’t like taking medications or they cause side effects, you may want to consider epilepsy surgery, which has good success rates of reducing and even eliminating seizures in many patients.

When should I consider epilepsy surgery?

If you have epilepsy and medication isn’t controlling your seizures to the extent you would like, it might be time to consult an epilepsy expert. Or, if you are currently receiving care from a neurologist but feel like your current line of treatment is ineffective or not meeting your goals, neurosurgeons at Neurosurgery One can review your case and offer insights into more epilepsy treatment options, such as epilepsy surgery.

Thanks to advancements in technology and epilepsy research, nearly every adult with uncontrolled seizures is now a candidate for epilepsy surgery. You do not have to wait a certain amount of time. In fact, new research has found that earlier surgery can produce better results. In particular, surgery that reduces or eliminates epileptic seizures helps patients maintain jobs and other activities, which also helps reduce any related depression or anxiety.