Frequently Asked Questions
An estimated 1% of the population has epilepsy. In Florida that's more than 145,000 people. The Epilepsy Foundation of America estimates that 2,500,000 Americans have epilepsy.
A seizure is a sudden, spontaneous and excessive discharge of brain cells that causes a temporary change in behavior or a loss of control of all or part of the body. A change in consciousness may also occur during a seizure.
Seizures can have many characteristics. A seizure may affect a person's sight, sense of smell, taste, emotion, movement, or memory. A person having a seizure cannot will his or her body to stop movements or activities, or respond to instructions. The extent to which normal activities are affected depends on how much of the brain is involved in the seizure. Abnormal electrical activity limited to a part of the brain is called a partial seizure. Seizure activity that involves the entire brain from the outset is called a generalized seizure. Seizures that begin in a part of the brain and spread to involve the entire brain are called secondarily generalized seizures.
Epilepsy is a disorder of the central nervous system. It can be caused by injury or trauma to the brain such as a head injury, diseases that affect the central nervous system like meningitis or encephalitis, stroke, poisoning, or lack of oxygen to the brain. More than half the cases of epilepsy are idiopathic or have no identifiable origin. Many of these are believed to be genetic.
Epilepsy is not a disease and is not contagious.
New cases of epilepsy most often occur in children and the elderly. However, epilepsy can occur at any age.
Not necessarily. Epilepsy is a disorder characterized by recurring, unprovoked seizures.
An estimated 1 out of 10 people will have a single seizure at some time during their life. These seizures can be caused (or provoked) by metabolic imbalances (such as imbalances in the level of sodium, magnesium, fluids, or glucose), stress, fever, or sleep deprivation. Of those, only a small number will have recurring seizures.
Every one of us has a seizure threshold, or a susceptibility to have a seizure. People with epilepsy have a lower seizure threshold than people who do not.
A diagnosis is based on personal and family history, a neurologic exam, and diagnostic tests such as an EEG or MRI. An EEG (electroencephalogram) looks at the function of the brain by recording electrical activity. An MRI (magnetic resonance imaging) looks at the structure of the brain and helps identify areas of injury or trauma.
Most often, the first course is treatment is the use of one or more of the antiepileptic medications available today. The choice of which medication depends on the type of seizure(s) being treated, side effects of the medication of choice, the patient's age, other medical conditions, and so on. If after reasonable trials on the medications of choice, adequate seizure control is not obtained, alternative treatments may be discussed and considered.
If you are interested in any of the alternatives below, talk with your doctor to see if you may be candidate for an alternative treatment. Never discontinue taking your medication without your doctor's guidance.
Surgery. Surgery is an option for some people with epilepsy whose seizures cannot be controlled by medications. Surgery may include removal of the seizure focus (or beginning point) or severing nerves that connect the two hemispheres of the brain.
Ketogenic diet. This is a very strict diet that has been used on a limited basis since the 1920's. The diet must be started and continued under the care of a specialist. Studies indicate that 1/2 - 1/3 of children who try the diet will experience varying degrees of improvement in seizure control. A statement by the Child Neurology Society regarding the ketogenic diet, written by Dr. John Freeman, can be found in the resources listed below.
Vagus Nerve Stimulator. This device, recently approved by the FDA, consists of a generator (about the size of a pacemaker) implanted in the chest and a wire that is connected to the vagus nerve. The device sends mild intermittent electrical impulses through the vagus nerve to the brain.
Complementary Therapies. Acupuncture, aromatherapy, biofeedback, relaxation therapy and meditation have also been used with varying degrees of success to control seizures.
You probably do. In almost half of the people with epilepsy, seizures are completely controlled with the use of medication. You may never know he or she has this disorder. Some well-known people believed to have had epilepsy include Julius Caesar, Napoleon Bonaparte, Charles Dickens, Leonardo da Vinci and Socrates.
Witnessing a seizure can be a frightening experience. This is especially true if you are not prepared to respond to the seizure. No matter what type of seizure the person has, the best thing you can do is to keep calm, protect the person from injury and reassure him or her. The other thing you can do for any person having a seizure is to be a good observer. The information you provide about events before, during, and after a seizure can be very helpful to the doctor. For specific seizures:
Tonic-Clonic Seizure (sometimes called a grand mal or convulsive seizure)
Tonic-clonic seizures, or convulsions, include a sudden cry, fall, and stiffening of the body, followed by muscle jerking.
Most seizures in people with epilepsy are not a medical emergency, however, call 911 if
Absence Seizure(sometimes called a petit mal seizure)
There is very small chance for injury during these brief seizures. Typically, the person will stop what he or she is doing and stare for a few seconds. The person does need reassurance that you will stay with him or her until the seizure is over.
Complex Partial Seizure
Complex partial seizures are characterized by staring followed by repetitive, inappropriate movements, inability to communicate, and/or wandering. If someone is having a complex partial seizure, you can assist by following these simple steps:
Typically, seizures last from a few seconds to a few minutes, depending on the type of seizure. Recovery from a seizure (the postictal period) may last several minutes to several hours.
Some people with epilepsy have a warning, or an aura, before a seizure. Auras can be very helpful in allowing a person to get to a safe place before the onset of a seizure. An aura is actually a type of partial seizure it may be an emotion, a sensation, an odor or a nauseous feeling, to name a few. Auras should be reported to the doctor when reporting seizures.
Other people may experience a "prodrome" before a seizure. A "prodrome" has been likened to the feeling you may have before you get a cold or the flu, an "awareness" that you are about to become ill.
There are a number of events that may lower the seizure threshold or may "trigger" a seizure in someone who has epilepsy. Some of the more common events include use of alcohol, lack of sleep, stress, menses, illness, or fever. Some people with epilepsy have reflex epilepsy, and may have seizures "triggered" by flashing lights, video games, a bar of music, reading, etc. Reflex epilepsy is relatively uncommon.
There are a number of things a person with epilepsy can do that may help reduce the number of seizures that occur. They include:
In some instances, the cause of epilepsy can be prevented or avoided. Preventing a head injury is a good example. Wearing protective head gear for sports, helmets when cycling and skating, a hard hat on construction sites, properly using safety belts and child restraint seats, and keeping walkways and stairways clear to prevent falls, can help prevent a head injury in the event of an accident. If a head injury is sustained, promptly seek medical attention. Other prevention strategies include:
Everyone should know about epilepsy and how to respond to seizures. You never when someone you love or care about may experience seizures.
To find out about services for people with epilepsy in your area and who is eligible for services, contact the Epilepsy Services Provider in your county.
There are hundreds of wonderful websites to visit to learn more about epilepsy. A few of them are listed on our links page.