Epilepsy is a common neurological disorder that causes people to have recurrent seizures.

A seizure happens when there is a sudden surge in electrical activity in a person’s entire brain, or in parts of it. This sudden increase in brain activity leads to seizure symptoms such as muscle spasms. A common misconception is that all seizures involve convulsions. However, this is not the case for everyone with epilepsy – there are many types of seizures, depending on which part of the brain is affected, and some are more serious than others.

Furthermore, not all people who experience seizures have epilepsy. An in-depth medical examination including blood tests and electroencephalography (EEG; a test that records brain activity) needs to be carried out to diagnose a person with epilepsy.

Epilepsy can affect people of all ages, all races and ethnicities, and all social classes, but it is more frequently diagnosed in children and those over the age of 65. According to the Epilepsy Society, around 1 in 100 people (or half a million individuals) are diagnosed with epilepsy in the United Kingdom. This number stands at around 3.4 million in the United States, with over 150,000 new cases each year.

Causes

The causes of epilepsy can be complex and tricky to pinpoint. Nevertheless, some reasons why people develop epilepsy could include: a genetic tendency to have seizures that is passed down from one’s parents, or structural changes in the brain brought about by head injury, infections of the brain, a stroke, or a brain tumour. It is also possible for a person to have both a genetic tendency and a structural change to their brain.

Treatment

Epilepsy can be treated through a variety of ways.

Medications such as anti-epileptic drugs (AEDs) are taken regularly to prevent epilepsy. These drugs work by reducing excessive activity in the brain. About 7 in 10 people can have epilepsy that is completely controlled by taking medication and by having a suitable lifestyle. Some people may notice that their seizures are triggered by stressful situations, health problems, or habits such as not getting enough sleep. A suitable lifestyle would thus entail avoiding or managing these triggers to prevent seizures from occurring. Other individuals may have epilepsies that spontaneously remit (they stop having seizures) and they may be able to stop taking AEDs.

When people with epilepsy find that taking medications are unhelpful for preventing their seizures, they may be advised to consider surgery. Surgery may be useful when the seizures are caused by excessive activity in a very specific area of the brain. This affected area can then be removed (completely or partially) through surgery, without damaging other important parts, for example, brain areas that are responsible for speech and language. Doing so will help to control the seizures, thereby improving the person’s quality of life.

Dietary therapies are commonly utilised for treating children (and sometimes adults) who do not respond to medications and when surgery is not an option. An example of a diet that may be implemented is the high fat and low carbohydrate ketogenic diet. Such dietary therapies should only be conducted with the strict guidance and supervision of a trained medical professional and dietician.

Other treatments include Vagus Nerve Stimulation (VNS) and Responsive Neurostimulation (RNS) that encompass small devices being implanted under the skin on the left side of the chest or the skull respectively. The benefits of such treatments are usually seen in the long-term, over a period of a few years.

First Aid For Seizures

If you witness someone experiencing what you suspect might be a seizure, try to stay calm. Most seizures will pass after a few minutes and do not require emergency medical attention.

However, if the seizure lasts longer than 5 minutes or if there are signs of injury, sickness, or difficulty breathing, call an ambulance immediately. If you know that the person experiencing a seizure does not have epilepsy, it is also crucial to seek medical help as this may be a sign of a more serious illness.

Should the person have a tonic-clonic seizure (a major seizure; when their body stiffens, jerks, and shakes and they may lose consciousness), you may carry out first aid by following these steps:

  1. Time the seizure to determine how long it lasts and if the person requires emergency medical attention.
  2. Move any objects away from them and place a soft jacket or cushion under their head so that they do not hurt themselves.
  3. Once the shaking stops, you should gently roll them over on their side into a recovery position.
  4. Check that they are not having any breathing difficulties. If their breathing sounds abnormal, open their mouth to check that nothing is blocking their airway.
  5. If necessary, wipe any spit away from their mouth and try to minimise any embarrassment.
  6. Speak calmly and reassuringly, and stay with them until they have recovered from the seizure.

It is important to remember that epilepsy is not contagious, is not a mental illness, and is not a developmental disability. Debunking these myths can go a long way in eliminating the stigma that is frequently associated with epilepsy and raising awareness on how we can provide adequate support to people with epilepsy in times of need.

For more information on epilepsy, visit epilepsy.com or epilepsysociety.org.uk. In addition, do look out for our infographic on the different types of seizures and their symptoms!

References

Epilepsy Foundation. New to Seizures & Epilepsy. 2014. Electronic. 13 December 2018. https://www.epilepsy.com/sites/core/files/atoms/files/NewToSeizuresAndEpilepsy.pdf

Epilepsy Foundation. What is Epilepsy? 2014. Electronic. 13 December 2018. https://www.epilepsy.com/learn/about-epilepsy-basics/what-epilepsy

Epilepsy Society. First Aid For All Seizures. 2018. Electronic. 13 December 2018. https://www.epilepsysociety.org.uk/first-aid-all-seizures#.XBHzGBMzYWo

Epilepsy Society. What is Epilepsy? An Introduction. 2016. Electronic. 13 December 2018. https://www.epilepsysociety.org.uk/sites/default/files/attachments/WhatisepilepsyDec2016.pdf

The Epilepsy Centre. What is Epilepsy? 2018. Electronic. 13 December 2018. https://epilepsycentre.org.au/what-is-epilepsy/