Epilepsy

Wes, who has epilepsy (pronounced: EH-puh-lep-see), spent most of his freshman year worried about having a seizure in front of his new classmates. Even though his teachers and friends knew of his condition — and Wes knew that he'd be OK if he did have a seizure — he was always concerned that he'd embarrass himself or scare his friends.

What Is Epilepsy?

Epilepsy is a condition of the nervous system that affects 3 million Americans. More than 150,000 people are diagnosed with epilepsy every year.

It can be hard to know if someone is having an epileptic seizure. While some people have convulsions of their whole body, others simply stare blankly into space for a few seconds. The person may lose consciousness or seem unaware of what's going on, make involuntary motions (movements the person has no control over, such as jerking or thrashing one or more parts of the body), or experience unusual feelings or sensations (such as unexplained fear). After a seizure, he or she may feel tired, weak, or confused.

People have seizures when the electrical signals in the brain misfire. These overactive electrical discharges disrupt the brain's normal electrical activity and cause a temporary communication problem among nerve cells.

Having a seizure doesn't always mean that a person has epilepsy. Seizures can be triggered in anyone under certain conditions, such as life-threatening dehydration or being severely overheated. But when a person experiences repeated seizures for no obvious reason, that person is said to have epilepsy.

Many people develop epilepsy as children or teens. Others develop it later in life. For some people with epilepsy (particularly kids), the seizures eventually become less frequent or disappear altogether.

What Causes Epilepsy?

This's no clear-cut answer to why people have epilepsy. Often doctors can't pinpoint the exact cause of a person's epilepsy. But scientists do know that some things can make a person more likely to develop epilepsy, including:

• a brain injury, such as from a car crash or bike accident
• an infection or illness that affected the developing brain of a fetus during pregnancy
• lack of oxygen to an infant's brain during childbirth
• meningitis, encephalitis, or any other type of infection that affects the brain
• brain tumors or strokes
• poisoning, such as drug abuse or lead or alcohol poisoning

Epilepsy is not contagious (you can't catch it from someone who has it). It's not passed down through families (inherited) in the same way that blue eyes or brown hair are. But someone who has a close relative with epilepsy has a slightly higher risk for it than somebody with no family history of seizures.

Understanding Seizures

Seizures may look frightening, but they're not painful. They affect different people in different ways. Epileptic seizures fall into two main categories: partial and generalized.

Partial seizures start in one part of the brain. The electrical disturbances may then move to other parts of the brain or they may stay in one area until the seizure is over.

Partial seizures can be either simple (where a person doesn't lose consciousness) or complex (where a person loses consciousness). There may be twitching of a finger or several fingers, a hand or arm, or a leg or foot. Certain facial muscles might twitch. Speech might become slurred, unclear, or unusual during the seizure. The person's vision might be affected temporarily. He or she might feel tingling throughout one side of the body. It all depends on where in the brain the abnormal electrical activity is taking place.

Generalized seizures involve electrical disturbances that occur all over the brain at the same time. These include several types of seizures including absence seizures (pronounced ab-SAHNTZ, also called petit mal), tonic-clonic seizures (also called grand mal), and myoclonic epilepsies. 

Absence seizures are more common in girls than in boys. In this type of seizure, the person may appear to be daydreaming or may stare off into space. After the seizure, which may last about 15 seconds or less, the person returns to their normal level of activity.

During a tonic-clonic seizure, a person’s eyes may roll back, the muscles may stiffen, and the person might make sudden jerking motions, such as flinging the arms outward. He or she may suddenly go limp and slump down or fall over. The person could also lose control of the bowel or bladder. 

Other types of seizures include myoclonic seizures and infantile spasms. Talk to your doctor to learn more or visit the Epilepsy Foundation website.

Most seizures last only a few seconds or minutes. After a seizure is over, the person might feel sleepy or confused for a few minutes or even an hour or more. People who've had seizures may not remember the seizure or what happened immediately before the event. They may be alert and ready to resume whatever they were doing before the seizure happened. It varies from person to person.

Certain things can sometimes trigger seizures in people with epilepsy. They include:

• flashing or bright lights
• a lack of sleep
• stress
• overstimulation (like staring at a computer screen or playing video games for too long)
• fever
• certain medications
• hyperventilation (breathing too fast or too deeply)

What Do Doctors Do?

Doctors who specialize in the brain and other parts of the nervous system are called neurologists (pronounced: nuh-RAH-luh-jists). If you think you might have had a seizure, it's important to tell your doctor about it. He or she will most likely refer you to a neurologist who will check for epilepsy or other conditions.

In addition to doing a physical examination, the neurologist will ask you about any concerns and symptoms you have, your past health, your family's health, any medications you're taking, any allergies you may have, and other issues. This is called the medical history. It's important to give the most accurate description possible of the seizure (or seizures). Identifying the type of seizure a person has helps the doctor decide how to treat it. Because people who've had seizures may not remember anything about them, it's a good idea to get a detailed description from someone who saw it and write it down afterward.

The neurologist will most likely perform medical tests such as an electroencephalogram (pronounced: eh-lek-tro-en-SEF-uh-luh-gram), or EEG test, to measure the electrical activity in the person's brain. Scans of the brain, such as a computerized tomography (CT) scan or magnetic resonance imaging (MRI) test, may also be done. All of these tests are painless.

If the neurologist determines that a person has epilepsy, he or she will recommend an appropriate type of treatment. Treatment for epilepsy usually involves medication, but sometimes other treatments can help. The goal of treatment is to control seizures so that a person can live as normally as possible. In some cases, doctors can implant a device called a vagus (pronounced: VAY-gus) nerve stimulator. This device sends signals through the vagus nerve in the neck to control seizures.

A doctor also may recommend a ketogenic (pronounced: kee-toe-JEH-nik) diet, a special diet that might help people with epilepsy who don't respond well to medication alone. Sometimes doctors can help by performing surgery directly on the brain tissue when the condition can't be controlled using other treatments.

Living With Epilepsy

People with epilepsy can and do live normal lives. Many athletes, authors, politicians, entrepreneurs, doctors, parents, and artists have epilepsy.

If you have epilepsy, you can still become involved in extracurricular activities, go on dates, and get a job. Your doctor will give you instructions about taking precautions to protect yourself in various situations. For example, teens with epilepsy can enjoy swimming, but should always swim with other people to be safe.

Aside from some minor safety precautions, though, you can enjoy all the stuff your friends and classmates do. As long as epilepsy is under medical control, people with epilepsy are able to drive.

Tell the people close to you — friends, relatives, teachers, coaches — about your epilepsy and teach them what to do in case you have a seizure when they're with you. Some of the things friends can do to help someone who's having a seizure are:

• Stay calm.
• Help, but don't force, the person to lie down on his or her side, preferably on a flat, comfortable surface.
• Take the person's glasses or backpack off and loosen any tight clothing near the neck.
• Don't restrain or hold the person.
• Move objects, especially sharp or hard ones, away from the person.
• Stay with the person or make sure another friend or trusted person stays with him or her.
• Make sure your friend's breathing is OK.
• Talk with the person in a calm, reassuring way after the seizure is over.
• Observe the event and be able to describe what happened before, during, and after the seizure.
• Don't put anything into the person's mouth during a seizure. Your friend won’t swallow his or her tongue, and forcing the mouth open may cause an injury.

There's usually no need to call 911 if the person having a seizure is known to have epilepsy. However, if the person is injured, is having breathing problems or appears bluish around the mouth, has another medical condition like diabetes, or has a long seizure (more than 5 minutes) or multiple seizures, he or she may need medical attention.

Epilepsy sounds frightening, but managing it can be simple. If you have epilepsy, follow your treatment plan. Get plenty of sleep. Eat right. And exercise to reduce stress and stay in shape.

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