If you or someone you know has been recently diagnosed with epilepsy, you are sure to have a lot of questions about what this means. Here is a straightforward guide to epilepsy that explains all the fundamentals you might want to know.
What is epilepsy?
Epilepsy is a medical disorder that affects the brain. People with epilepsy are at an increased risk of having recurrent seizures.
Seizures are episodes of abnormal electrical activity in the brain. During a seizure, the brain is not able to function as it usually would.
If you have had a seizure, do you have epilepsy?
Having one seizure does not mean that you have epilepsy. There are many people who have one seizure and never go on to have a second seizure.
Epilepsy is usually not diagnosed by a doctor until someone has had at least two seizures.
Who is at risk of epilepsy, and what are the underlying causes?
Epilepsy is more common in children and those over 60 years. However, it can affect men and women of all ages, and across all races.
In most cases, there is no cause of epilepsy identified. When there is a cause found, it can be due to one of the following reasons:
Alcohol and other drugs
Certain immune conditions
What are the symptoms of epilepsy?
Seizures are the main symptom of epilepsy. The overall effect of a seizure depends on where in the brain it is happening. Some seizures affect only a small part of the brain, whereas others can involve the entire brain.
If a seizure affects a small part of the brain at its onset, it is known as a focal seizure. Focal seizures sometimes spread to involve other parts of the brain.
If you are having a focal seizure, there are a range of possible symptoms. Here are a few:
Jerking or twitching of part of the body
Experiencing a sudden strong smell (which no one else around you can smell)
A striking emotion (often distressing) that does not fit with the situation you are in
An overwhelming sense of deja vu (a feeling that you have lived through the present situation already) that stops you in your tracks
An unusual sensation in your gut that spreads in waves up to your chest or throat
If a seizure affects the whole brain from the start, it is called a generalised seizure.
Because these seizures affect the whole brain, they often cause a loss of awareness or even loss of consciousness. So, people who experience these seizures will frequently have no memory of them.
Some clues that you may have had a generalised seizure are:
'Blank periods' – when time passes that you cannot account for
Collapsing, followed by loss of consciousness that takes a significant time to recover from
Having a severe tongue bite that you cannot explain
It can be helpful to hear how onlookers who have witnessed the seizure describe it.
What are the treatment options?
Oral medications (most often in tablet form) are the primary type of treatment for epilepsy. These medications are often called anti-epileptic drugs (AEDs) by medical professionals. The aim of these medications is to prevent future seizures.
In rare cases, there are surgical treatment options. However, the vast majority of patients with epilepsy do not require surgical treatment.
The ketogenic diet (extremely low carbohydrate intake) is another potential treatment option. This diet is usually only advised in people with severe epilepsy, who have already taken anti-epileptic drugs. It requires significant expertise, and should not be tried without professional help.
You've been diagnosed with epilepsy – what next?
Most people who have epilepsy live a normal, fulfilling life. Although there is no cure for epilepsy, anti-epileptic drugs result in prolonged periods of seizure freedom for the majority of people.
If you have been diagnosed with epilepsy, it's a good idea to let those close to you know. That way, they can educate themselves on the best ways to help you if you do have a seizure.
Different countries have different regulations regarding driving, but in general, there is a period where you can not legally drive after a seizure.
If you have epilepsy, seizures can increase your risk of injury. It is, therefore, a good idea to review your usual activities and perform a checklist of safety questions to minimise your risk of harm.
Where can you get more help?
Your health professionals can be a great source of information if you want to know more about epilepsy. It's a good idea to make a list of any questions that come to your mind. You can then discuss these topics with your health care provider at your next clinic visit.
Epilepsy Ireland is a fantastic online resource, with links to the different support services that are available.