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Sunday, May 19, 2013
About one in 100 people in the United States have experienced an epileptic seizure or been clinically diagnosed with epilepsy.
Epilepsy is a neurological disorder in which the brain experiences abnormal, synchronous electrial activity which results in a seizure. These seizures classically take one of several forms and are most commonly characterized by:
About 65% of epilepsy cases can be easily treated with medication while others may respond to surgery. There are other treatment options for those with difficult to control seizures. In some cases, usually involving children and adolescents, symptoms may simply end.
Having one isolated seizure does not mean that someone has epilepsy; multiple seizures are required for proper diagnosis.
Some cases of epilepsy have an easily identified cause but many cases of epilepsy have an unknown cause. Currently researchers believe that a combination of genetic and environmental factors is responsible for epilepsy.
Genetic factors increase the likelihood of improper brain wiring. It is theorized that up to five hundred individual genes may influence susceptibility to epilepsy. Although mental retardation can be responsible for epileptic seizures, epilepsy does not cause or indicate other mental illnesses and usually has minimal degenerative affects.
Environmental factors such as exposure to lead, carbon monoxide, and other poisons activate repeated seizures.
Traumatic head injury may also result in epilepsy, but one event at the time of the accident does not necessarily indicate the disorder. Unfortunately, not all cases of epilepsy have known causes and remain a mystery for scientists and doctors.
Within epilepsy there are different syndromes that are differentiated by the patient's symptoms. Several common types are:
Absence epilepsy involves momentary unconsciousness during a seizure and usually affects patients from infancy through adolescence.
TLE (temporal lobe epilepsy) usually begins in childhood with focal seizures and has degenerative effects on the hippocampus (a part of the brain).
Neocortical epilepsy is where the patient's seizure originates in the outer section of the brain which may cause a variety of symptoms depending on the location of the seizure.
Lennox-Gastraut syndrome begins in childhood and causes the patient to have atonic seizures that may prove difficult to treat.
An epileptic seizure is a sudden and extreme change of neural dynamics. It is difficult to describe these seizures as a group because their physical manifestations are drastically different. In some seizures the person becomes completely motionless while others cause the person to collapse and violently convulse. Doctors have differentiated seizures into as many as 30 different categories that fall under the headings of generalized and focal.
Generalized seizures affect the entire brain and may also be referred to as local seizures. There are six major types of seizures:
Each has its own characteristic motions that vary greatly between types.
Partial seizures affect a specific location in the brain and are more common than general seizures. In this type of seizure electrical activity originates in a small portion (focus) of the brain. This chaotic signal can be measured using an EEG (multi-electrode electroencephalogram) to pinpoint the source of the problem. Within this category there are:
Partial seizures, like generalized seizures, have characteristic symptoms that help with treatment and diagnosis.
Further information on specific types of seizures can be found elsewhere on the epilepsy page.
Scientists are exploring a variety of avenues for treating epilepsy. Some of the research conducted is basic science to discover the underlying mechanisms that influence brain function. Meanwhile, geneticists are working on finding the genes responsible for epilepsy with the long term goal of using one's genetic code to determine how to best treat his or her epilepsy or even prevent epilepsy through genetic manipulation. Other research is focused on pharmaceutical treatments for the condition to help improve function within individuals and also to broaden the population that can be helped. More cutting edge research involves implanting cells into the brain and the creation of a device that can predict seizures before they occur and warn the individual.
Patients with epilepsy may feel increased social pressure because of the nature of uncontrolled and undesired symptoms of the condition. This has been more prevalent in the past, but may still be seen today, especially in children and adolescents. Seizures in social settings may embarrass the epileptic child and have a negative impact on the surrounding students who might tease or avoid that person thereafter.
In the most extreme cases, consequences of this type of social devaluation increases the risk of low self-esteem, depression, and worse, suicide. Family support and encouragement is essential for minimizing the effect of social stigma and feeling of isolation common to epileptics.
If you or someone you know may have epilepsy, contact your healthcare professional immediately. There are many treatments available for this brain disorder.
National Institute of Neurological Disorders and Stroke ? Seizures and Epilepsy: Hope Through Research
Carlton-Ford, S., Miller, R., Brown, M., Nealeigh, N., Jennings, P. (1995). Epilepsy and Children's Social and Psychological Adjustment. Journal of Health and Social Behavior, Vol. 36, 285-301.
Prepared in partnership with Kevin McHugh, BS (class of 2009), Case Western Reserve University School of Engineering.
This article is a NetWellness exclusive.
Last Reviewed: Oct 07, 2010
David M Ficker, MD
College of Medicine
University of Cincinnati