Seizures and Epilepsy
An estimated 65 million people around the world have epilepsy. Epilepsy is a brain disorder that results in seizures or convulsions caused by surges in the electrical signals in the brain. These surges may cause a variety of behaviors, including blank stares, temporary confusion, jerking movements or violent muscle spasms, or a loss of consciousness.
Epilepsy can stem from brain injury, illness, or abnormal brain development, but there's often no detectable cause.
Seizures are a symptom of epilepsy, but having a single seizure does not necessarily mean you have epilepsy. A number of factors can affect the brain enough to cause a single seizure, such as high fever, severe head injury or lack of oxygen.
The nature and degree of epilepsy symptoms vary depending upon the type of seizure. Some seizures end with a loss of consciousness, others do not. Generally speaking, there are two major categories of epilepsy symptoms: partial seizures and generalized seizures.
Partial seizures occur in just one part of the brain. During a partial seizure, a person may or may not remain conscious, and may experience unusual feelings or sensations that can take many forms. Some types of partial seizures may cause involuntary movements in only a part of the body. The person may experience sudden and unexplainable feelings of joy, anger, sadness or nausea. He or she also may hear, smell, taste, see or feel things that are not real.
Generalized seizures are a result of abnormal neuronal activity on both sides of the brain. These seizures may cause loss of consciousness, falls or massive muscle spasms.
Not all seizures can be easily defined as either partial or generalized. Some people have seizures that begin as focal seizures but then spread to the entire brain. Other people may have both types of seizures but with no clear pattern.
Therapies for Epilepsy Patients
Available therapies commonly offered to patients include medications, vagus nerve stimulation, surgery and diet.
- Medications: The most common epilepsy treatment is antiepileptic drugs. Antiepileptic drugs successfully prevent seizures in the majority of people who take them regularly and as prescribed.
- Vagus nerve stimulation (VNS): VNS is currently approved for use in adults and children over the age of 12 who have partial seizures that resist control by other methods. The stimulator delivers energy by a flat, round battery, about the size of a silver dollar, which is surgically implanted in a patient’s chest. Thin wires (electrodes) are threaded under the skin and wound around the vagus nerve in the neck. The battery is programmed to send a few seconds of electrical energy to the vagus nerve every few minutes. If a patient feels a seizure coming on, he or she can activate the electrical discharge by passing a small magnet over the battery. In some people, this has the effect of stopping the seizure.
- Surgery: Unfortunately, some people continue to have seizures regularly despite taking medication. For them, surgery may be helpful. The type of surgery you will need depends upon several factors, including the type of seizures you have and where in the brain these seizures begin. These questions are answered during evaluation with your doctor
- Diet: Studies have shown that, in some cases, children may experience fewer seizures if they maintain a strict diet rich in fats and low in carbohydrates. Called the ketogenic diet, this way of eating causes the body to break down fats instead of carbohydrates to survive (ketosis). When carefully monitored by a medical team, the diet helps two out of three children and may prevent seizures completely in one out of three, according to the Epilepsy Foundation. It is a strict diet, and takes a strong commitment from the whole family.
- Other therapies: Some people say they feel better, or have fewer seizures, when they use remedies, such as folk medicines, herbs and megavitamin therapy. If your doctor has no objection, and regular medication is continued, these therapies could be beneficial. Stopping standard medication or a prescribed diet in favor of an unproved remedy, however, is risky and is not advisable.
Treatment options include monitoring, medications, surgery and neuropsychiatric evaluations and counseling. However, while medication is the mainstay of therapy for most patients with epilepsy, no two patients are the same and the choice of specific medication requires careful analysis and monitoring. Sentara Martha Jefferson Seizure and Epilepsy Clinic provides patients with the individualized care and monitoring that they need.