Epilepsy

Epilepsy is a brain disorder in which clusters of nerve cells, or neurons, in the brain can misfire. (Read about "The Brain") This in turn can lead to unusual sensations, emotions and behaviors; it can also cause convulsions, muscle spasms and loss of consciousness. According to the American Academy of Neurology (AAN), anyone can develop epilepsy, and about one in every hundred people is affected by it.

AAN says epilepsy may develop because of an abnormality in brain wiring, an imbalance of nerve-signaling chemicals called neurotransmitters, or some combination of these factors. It may result from a number of different causes, including injury to the brain (Read about "Head Injury"), brain infection or exposure to toxic substances, high fever, or impaired blood circulation to the brain, for example as the result of stroke (Read about "Stroke").

Types of epilepsy

Seizures can be classified as partial or generalized, depending on how the abnormal brain activity begins. Seizures that begin in just one part of the brain are called partial or focal seizures. Seizures that involve all of the brain are called generalized seizures.

Some examples of types of seizures include:

• Simple partial seizure - This type of seizure does not result in loss of consciousness, but can lead to changes in emotions or sensory perceptions.
• Complex partial seizure - This type of seizure does alter consciousness, so there can be blank staring or involuntary movements.
• Absence seizure - This type of generalized seizure is characterized by short periods of unconsciousness, with staring and some involuntary body movements.
• Myoclonic seizure - This is characterized by jerking movements of the limbs.
• Atonic seizures - This generalized seizure can cause someone to suddenly collapse.
• Tonic-clonic seizures - This is a very intense generalized seizure, with loss of consciousness and body stiffening and shaking.

There are also different types of epilepsy. Idiopathic generalized epilepsy can affect children, adolescents, and young adults, and often involves a family history of epilepsy. (Read about "Family Health History") Symptomatic generalized epilepsy is commonly the result of brain damage that occurs during birth. Symptomatic partial epilepsy can result from brain diseases, such as stroke or brain tumors, or congenital brain abnormalities. Benign focal epilepsy of childhood is a type of epilepsy that is found in children, and commonly outgrown. Childhood absence epilepsy is a genetic condition (Read about "Genetics"), characterized by periods of staring, and is also often outgrown.

Although many people associate seizures or convulsions as an indication of epilepsy, a number of other conditions, including illness or brain damage, can cause seizures too. Therefore, having a single seizure does not necessarily mean that a person has epilepsy. The National Institute of Neurological Disorders and Stroke (NINDS) says that only when a person has had two or more seizures is he or she considered to have epilepsy. (Read about "Seizures") EEGs and brain scans are common diagnostic tests for epilepsy. (Read about "EEG - Electroencephalograph")

Treatment options

The Centers for Disease Control and Prevention (CDC) say that before beginning treatment, you need to know the type of epilepsy and whether there are any other underlying conditions involved. Antiepileptic drugs are the mainstay of treatment for most people, according to CDC. According to the Epilepsy Foundation, there are over twenty different medications that can control the symptoms of epilepsy. Your doctor may recommend one or more of these drugs, depending on the type of epilepsy, the frequency and severity of the seizures, age, and related health conditions. With any medication, close monitoring is required to check for effectiveness as well as possible side effects.

If medications are not effective, there are other options. The vagus nerve stimulator (a small battery which is surgically implanted in the chest and sends signals to the brain via the vagus nerve, found in the neck) is also used in people with seizures that are not well-controlled by medication. Another option is a small neurostimulator which is implanted under the scalp. Surgery to remove the seizure-producing areas of the brain has been used for many years, when medication has failed to prevent seizures. (Read about "Neurosurgery") A carefully monitored high-fat or ketogenic diet is also sometimes used for short periods of time with children to control seizures.

According to the Epilepsy Foundation, new surgical techniques and improved ways to pinpoint the location of the problem areas, have improved the success rate for surgical treatment. However, the Foundation adds, surgery is not suitable for everyone and the issue should be discussed with your doctor. Whatever the most appropriate treatment, it's important that treatment begin as soon as possible after epilepsy is diagnosed. This is especially true for children, who may develop emotional problems as a result of their disease and the reaction of their peers.

Although the disease cannot currently be cured, for some people it does eventually go away. According to NINDS, for about 80 percent of those diagnosed with epilepsy, seizures can be controlled with modern medicines and/or surgical techniques. Meanwhile, research continues into how neurotransmitters interact with brain cells to control nerve firing and how non-neuronal cells in the brain contribute to seizures. Efforts are also underway to improve MRI (Read about "MRI - Magnetic Resonance Imaging") and other techniques to study how the brain works. In addition, scientists are trying to develop ways to predict when seizures may occur, and to develop new drugs and other techniques that can control the symptoms.

Precautions

If you are with someone who has a seizure, AAN says to keep calm, help the person to the floor and loosen clothing around the neck. After that, AAN says do NOT put anything into the persons mouth, but you should remove any sharp or hot objects nearby that could injure the person, turn the person on one side so saliva can flow out of their mouth and place something such as a cushion under their head. If you know the person has epilepsy, AAN says an ambulance is probably unnecessary. However, an ambulance can be appropriate if:

• the seizure continues for more than five minutes
• you don't know if the person has epilepsy
• the person is pregnant, diabetic, or seems otherwise ill

Anyone diagnosed with epilepsy also needs to take special precautions. Some may need to restrict their driving. People with epilepsy are also at special risk for two life-threatening conditions: status epilepticus and sudden unexplained death. NINDS says that most women with epilepsy can become pregnant (Read about "Healthy Pregnancy"), but they should discuss their epilepsy and the medications they are taking with their doctors. Women who wish to avoid pregnancy should also discuss potential effects of their anti-epileptic drugs with their doctors.

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