Epilepsy in a Nutshell

 WHAT IS EPILEPSY?

Epilepsy is a tendency to have recurrent seizures.

A seizure is caused by a sudden burst of excess electrical activity in the brain, causing a temporary disruption in the brain’s messages causing them to be halted or mixed up.

Although there are over 40 types of seizures they can be split into 2 main groups:

Focal - where only a specific area of the brain is effected, what the individual experiences will be dependent on the area of the brain effected.  The individual can be fully concious or have decreased conciousness.

Generalised - where the whole of the brain is effected, these include tonic-clonic (formally grand-mal) and absences (formally petit mal).

CAUSES

There are two main causes:

Symptomatic where there is an obvious cause e.g. head injury, infection, brain damage at birth or brain tumour

Idiopathic where there is no know cause (this is the case in 6 out of 10 people)

There are many things which can trigger seizures, a few examples are:

Tiredness
Alcohol or Drugs
Stress
High Temperature
Flashing Lights (but this is only a small number of people)

However often people cannot identify a clear trigger.

DIAGNOSIS

There is no conclusive test for epilepsy, although tests such as the electroencephalogram (EEG) – which records brainwave patterns - can help to strengthen a diagnosis. The most important tool in diagnosis is a clear discription of what happened.  An epilepsy specialist will use their own expert knowledge, along with test results and the patient’s or witness’s accounts of the seizures, to make the diagnosis.

Because epilepsy is currently defined as the tendency to have recurrent seizures, it is unusual to be diagnosed with epilepsy after only one seizure. In the UK around one in 20 people will have a single seizure at some point in their life, whereas one in 103 people have epilepsy.

TREATMENT

Epilepsy is usually treated with anti-epileptic drugs (AEDs). Most people find they have fewer or no seizures with these drugs.

In a small number of cases AEDs don’t work very well for a person, in these cases there are some other treatments that may be helpful such as brain surgery, vagus nerve stimulation and the ketogenic diet.