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Understanding epilepsy
Audience: patients-public, students-learners ยท Review state: published
What epilepsy is
Epilepsy is a long-term condition in which the brain's electrical activity is disrupted repeatedly, causing seizures. A single seizure does not mean epilepsy; the diagnosis is usually made after two or more unprovoked seizures, or after one seizure when tests show a high chance of more.
Seizures vary widely. Some involve convulsions and loss of consciousness; others are brief staring spells, odd sensations, or unusual movements while the person stays aware.
Causes and diagnosis
In many people no cause is found. Known causes include brain injury, stroke, infections of the brain, brain tumors, developmental conditions, and inherited factors.
Diagnosis rests on a careful description of the events, often from a witness, plus an EEG, which records the brain's electrical activity, and brain imaging. Other conditions such as fainting can look like seizures, so accurate diagnosis matters.
Treatment
Most people can control their seizures with anti-seizure medicines, taken regularly as prescribed. Missing doses is a common trigger for breakthrough seizures.
When medicines do not work, other options include surgery to remove the area where seizures begin, nerve stimulation devices, and dietary therapy in some cases. Sleep, stress, and alcohol also affect seizure control.
Safety and when to seek help
For a convulsive seizure, the helpful steps are to stay with the person, cushion the head, turn them onto their side once the shaking stops, and time the seizure. Nothing should be put in the mouth.
Emergency help is needed if a seizure lasts more than five minutes, if another follows without recovery, if the person is injured or pregnant, or if it is a first seizure. Living well with epilepsy usually involves sensible precautions around water, heights, and driving rules set by local law.
Limitations
General educational overview, not medical advice and not a diagnosis. Seizure diagnosis and medicine choice need a clinician, and a prolonged or first seizure is an emergency.