Epilepsy is one of the most common of medical conditions. It has been known since antiquity, although, as with almost everything in the medical field, the almost-like-a-miracle treatments are new. Yet despite its being commonplace, it can, and too often is, misunderstood. Even by family members and friends. Well controlled epilepsy, meaning no seizures, is a welcome relief. We sort of know what causes a seizure. Not exactly, but sort of. The good news is that medications and other treatments, medical and surgical treatments, are good and getting better.
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The one medical term “epilepsy” is applied to a broad range of conditions and, as a result, it’s meaning for any one person might be a bit unclear. Situations that occur in people’s brains can at times cause seizures. “Situations” is deliberately vague because many different central nervous system quirks can result in a single seizure or seizure disorder. While there are categories of seizure types and thus categories of epilepsy, in truth, each person’s epilepsy could be almost unique to them. Some are mild. For mild epilepsy a medicine taken every day can usually completely prevent seizures. Other forms of epilepsy can be severe and even deadly. The central problem with epilepsy is that nerve cells fire off abnormally. What the seizure looks like depends on which nerve cells fire. Seizures can look markedly different, one person to another. Most people, even those who are unfamiliar with epilepsy, are aware of convulsions, the big seizures. These are severe spasms of muscle groups that take over a person’s body. They cause falls and maybe cause one to lose awareness of their surroundings or lose consciousness. Seizures can cause lesser muscle motions. An arm, leg, or other body area might spasm or twitch.
Seizures Can Be of Emotions
If the nerve circuitry that is firing oddly are nerves in brain areas wherein emotions or feelings reside, the person might feel odd sensations or unfamiliar emotions. These might be emotions that are out of place, that is, emotions that do not fit the social situation at that moment. For example, a gelastic fit is a fit of out-of-place raucous laughter.
Putting Smaller Pieces into a Bigger Picture
Epileptologists, physicians who study and treat epilepsy, assemble these different movements and emotions together to form specific sets of symptoms. There are several common types of epilepsy and rare types. Altogether, there are too many types to list them all here without getting overly encyclopedic. Below are helpful links to sites with much, much more information.
Seizures Without Epilepsy
Having a seizure does not mean that a person has epilepsy. Environmental and physical situations that are not epilepsy can cause a seizure. Really high body temperature, a high fever, can cause a febrile seizure. A hard clunk on the head, head trauma, can cause a seizure. (American football is getting a bad reputation here.) To earn a diagnosis of epilepsy one has to have at least two seizures.
Making the Epilepsy Diagnosis
One can see most seizures. In addition to visible seizures there are tests that support making a diagnosis of epilepsy. There’s the EEG or “brain wave test” that shows brain’s electrical activity. The girl in the photo at the top of this page is having an EEG. Brain scans, like the MRI and the CT, are other tests to help make or rule out a diagnosis of epilepsy.
Getting treatment started right away, as soon as the diagnosis is certain, helps the most. Medically it helps. It’s good for the brain to not have seizures. It also helps with keeping your family calmer and keeping your friends. About three out of four people with epilepsy can have their seizures stopped or almost stopped with the today’s medications. A health care provider experienced in treating epilepsy will be skilled in matching the right treatment with the individual. Certain medicines work best for certain seizures.
The Eventual Clinical Outcome
With their seizures under control people do well. Once the seizures are under control a person can improve their situation at work, and their life at home and their social life also improve. The risk of having an unpredictable seizure is like a ball-and-chain on a person, holding them back. Driver’s licenses can be a problem. Job choice and hobbies are fewer if one might have a seizure at any moment. For example, it’s probably a bad idea to work high-rise construction or to have a hobby of underwater diving if you might have a surprise seizure. Computer programming and fine art painting are safer.
National Institutes of Health, National Institute of Neurological Disease and Stroke
National Library of Medicine (United States), Medline Plus
Center for Disease Control and Prevention (CDC)
American Epilepsy Society
The Mayo Clinic