What is Epilepsy?

Epilepsy is a common neurological disorder affecting about two in 100 people. Three out of four cases of epilepsy begin in childhood.

A seizure is caused when more than the usual amount of electrical energy passes through the brain. The portion of the brain affected by this “overload” causes temporary changes in body movement, consciousness and behavior.

Epilepsy is not contagious, it is not a disease. It can be caused by head injury, auto accidents, severe illnesses, tumors and other health conditions.

Recognition of seizure disorders and knowledge of first aid is important because it is very easy to mistake some seizures for other conditions.

Could it be Epilepsy?

Only a physician can say for sure whether or not a person has epilepsy. But many people miss the more subtle signs of the condition and therefore also miss the opportunity for early diagnosis and treatment.

The symptoms listed below are not necessarily indicators of epilepsy, and may be caused by some other, unrelated condition. If one or more is present, however, a medical check-up is recommended:

  • Periods of blackout or confused memory
  • Occasional fainting spells in which bladder or bowel control is lost, followed by extreme fatigue
  • Episodes of blank staring in children; brief periods when there is no response to questions or instructions
  • Sudden falls for no apparent reason
  • Episodes of blinking or chewing at inappropriate times
  • A convulsion, with or without fever
  • Frequent jerking movements in babies

How many types are there?

There are over 30 types of seizures classified into three major categories:

  1. Partial – arise in a specific portion of the brain
  2. Generalized – both hemispheres of the brain
  3. Unclassified – inadequate/incomplete data available. The most common seizure types are generalized tonic-clonic, absence and complex partial seizure.

Generalized Tonic-Clonic

Formally known as the “grand mal” seizure, this is a convulsive seizure affecting the whole body. The seizure may start with a crying out. The person falls, becomes unconscious and his body stiffens, followed by jerking motions. The person slowly regains consciousness but is tired and confused. The seizure usually lasts 2-4 minutes.

AbsenceSeizures

Formally called “petit mal”, it is most common in children. There is no aura before the seizure. The seizure consists of brief loss of consciousness (10-20 seconds). Staring and blinking is associated with this type of seizure, dozens or even hundreds may occur each day. They may be mistaken for day dreaming.

Complex Partial Seizures

Formally known as “psychomotor” or “temporal lobe” seizure; it is accompanied by an aura or “warning.” During the seizure, a person may have a glassy stare give no response, move aimlessly, make lip smacking or chewing motions, may appear intoxicated, drugged or psychotic. There may be struggle or fighting of restraint.

MYTHS & FACTS

About Epilepsy

Epilepsy is a disorder in which a person has two or more seizures without clear cause.

Most cases of epilepsy are not inherited. However, some types of epilepsy, most of them easily controlled with medication, are genetically transmitted, that is passed on through the family.

The word “epileptic” should not be used to describe someone who has epilepsy, as it defines a person by one trait. A label is powerful and can create a limiting and negative stereotype. It is better to refer to someone as “a person with epilepsy”.

Epilepsy has no single cause. In approximately 70% of cases, the cause is unknown. Epilepsy may be caused by head trauma, brain tumor, poisoning, infection or maternal injury.

Epilepsy can affect anyone at any age at any time. Some people are born with epilepsy; others develop it later in life.

Epilepsy can be treated and most people who receive treatment lead active and productive lives. Treatments include drug therapy, surgery, and dietary therapy.

This is untrue. People with epilepsy do not typically have developmental disabilities.

Epilepsy is not a life long disorder. Most persons with epilepsy do not have seizures or require medication all their lives. The majority of childhood forms of epilepsy are outgrown by adulthood.

I. Partial Seizure (seizures which involve or begin in one area of the brain)

A. Partial seizures with elementary symptomatology (seizures that have relatively uncomplicated symptoms.) Usually the person remains conscious.

  1. With motor symptoms (symptoms affecting the muscles, includes Jacksonian seizures)
  2. With special sensory or somatosensory symptoms (symptoms affecting the senses)
  3. With autonomic symptoms (symptoms affecting the internal organs)
  4. Compound forms (symptoms of more than one of the above types)

B. Partial seizures with complex symptomatology (partial seizures with more complicated symptoms, generally with some loss of consciousness- includes temporal lobe or psychomotor seizures)

  1. With impairment of consciousness only
  2. With cognitive symptomatology (symptoms affecting thought)
  3. With affective symptomatology (symptoms affecting mood or emotion)
  4. With “psychosensory” symptomatology (symptoms affecting sense perception, such as illusions or hallucinations)
  5. With “psychomotor” symptomatology (symptoms such as movement and behavior inappropriate to the situation- automatisms)
  6. Compound forms (symptoms of more than one of the above types)

C. Partial seizures secondarily generalized (seizures that begin as partial seizures and then become generalized

II. Generalized Seizures (bilaterally symmetrical and without local onset- seizures that involve both sides of the brain)

  1. Absences (brief lapses of consciousness occurring without warning and unaccompanied by prominent movements, as in petit mal)
  2. Bilateral massive epileptic myoclonus (an involuntary jerking contraction of the major muscles)
  3. Infantile spasms (brief muscle spasms in young children)
  4. Clonic seizures (seizures consisting of jerking movements of the muscles)
  5. Tonic Seizures (seizures in which the muscles are rigid)
  6. Tonic-clonic seizures (seizures which begin with muscle rigidity and progress to jerking muscular movement, commonly known as “grand mal” seizures)
  7. Atonic seizures (seizures in which there is a loss of muscle tone and the person falls to the ground)
  8. Akinetic seizures (seizures in which there is a loss of muscle movement)

III. Unilateral Seizures (seizures involving one hemisphere, or half, of the brain and consequently affecting one side of the body)

IV. Unclassified Epileptic Seizures (seizures which, because of incomplete information, cannot be put in a category)

Glossary
Absence Seizure
A generalized seizure in which consciousness is altered, formerly called petit mal, a term now seldom used. It is usually brief; similar seizures occur many times in a day. The EEG pattern is three-per-second spikes and waves. Absence seizures are usually easily treated and usually outgrown.
Ambulatory monitoring
The use of a cassette-like tape recorder to monitor the EEG while an individual is awake, at work, school, or play. The ambulatory monitoring device permits up to seventy-two hours of recording on tape. However, the amount of information produced about specific parts of the brain is limited. Since either the child or another observer must mark events thought to be seizures, and because the amount of EEG information is limited, ambulatory monitoring is useful only in special stimulations where it is important to clarify the nature of the spell (i.e., faint vs. seizure) and where quantification of spells is important. The procedure is far less expensive than video-EEG monitoring, but also less definitive.
Antiepileptic drug (AED)
Also called anticonvulsant drug. One of the drugs used to prevent recurrence of seizures. The particular drug chosen for a child depends on the type of seizures, the age of the child, and the type of side effect that might be expected.
Association cortex
The part of the brain in the parietal lobe where vision, hearing, memories, and motor function come together and where associations occur between sensations, movements, and thoughts.
Atonic seizure
A form of generalized seizure in which body tone is suddenly lost and the child slumps to the ground or his head slumps forward. These difficult to control seizures often occur in Lennox-Gastaut Syndrome (LGS). They may resemble the sudden seizure in which the child is thrown to the ground, often injuring his face or teeth. Atonic seizures and Myoclonic seizures often occur in the same child, and the terms are often used interchangeably.
Atypical absence seizure
A staring spell similar to an absence seizure but often with an atypical EEG. It may last longer than the typical absence seizure and may have other additional features (movement, falling, etc). Atypical absence may be more difficult to control with medications than typical absence seizures.
Aura
The start of a seizure. It is usually described as a warning – a peculiar feeling, a sense of fear, a funny sensation in one part of the body. The neural activity indicated by these sensations can spread to other areas of the brain. If the seizure does not spread, the aura would be referred to as a simple partial seizure.
Automatism
The complex and purposeless automatic movements that accompany a complex partial seizure. These movements often consist of smacking of the lips, chewing, picking at clothes, or wandering around in a confused fashion.
Autonomic nervous system
The part of the brain that controls functions like heart rate, blood pressure, and skin temperature and color. Seizures from the temporal lobe can produce disturbances of autonomic function.
Axon
The part of a neuron that resembles a telephone line and is responsible for the capacity of brain cells to communicate with one another.
Benign rolandic epilepsy
A special form of seizures in children that starts after three years of age. The seizure often begins with a sensation in the corner of the mouth, followed by local jerking of the muscles; it spreads to one side of the face, or one side of the body, and may become a generalized seizure. It has a typical EEG. These seizures occur more commonly during certain stages of sleep. They are usually outgrown.
Breathholding spell
An episode in which the child does not breathe, turns blue, and may lose consciousness. These spells may, on occasion, result in a seizure. Breathholding spells are not serious and are not epilepsy. There are two forms: cyanotic (blue) and pallid (white).
Clonic seizure
The rhythmic jerking of an extremity or the whole body. Seizures that are only clonic are rare. Clonic seizures are usually the second component of tonic-clonic seizures.

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