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What is a Seizure and What is Epilepsy?

Seizures — abnormal movement or behavior due to unusual electrical activity in the brain — are a symptom of epilepsy. But not all people who appear to have seizures have epilepsy.

What is Epilepsy?

Epilepsy is a group of related disorders characterized by a tendency for recurrent seizures. It is a physical condition caused by sudden, brief changes in how the brain works.

What Causes Epilepsy?

Epilepsy occurs as a result of abnormal electrical activity originating from the brain. Brain cells communicate by sending electrical signals in an orderly pattern. In epilepsy these electrical signals become abnormal, giving rise to an “electrical storm” that produces seizures. These storms may be within a specific part of the brain or be generalized, depending on the type of epilepsy.

Epilepsy can develop any time in life, but one third of the 125,000 new cases each year begin in childhood.

What causes epileptic seizures?

The brain is the control center for the body. Normal electrical signals between cells make the brain and body work correctly. The cells work like little switches, turning electrical charges on and off automatically. But sometimes it is as if some cells get stuck in the “on” position. This affects other cells and spreads to other parts of through all of the brain. It blocks out our usual awareness of things around us. It may change the way the world looks, or may make our bodies move automatically. Sometimes it may cause a convulsion. These seizures usually last a short time (a matter of seconds or a minute or two), and then end naturally as brain cell activity goes back to normal.

Epilepsy Symptoms

Almost any type of behavior that happens repetitively may represent a seizure.

Generalized seizures:

All areas of the brain (the cortex) are involved in a generalized seizure. Sometimes these are referred to as grand mal seizures.

  • To the observer, the person experiencing such a seizure may cry out or make some sound, stiffen for some seconds, then have rhythmic movements of the arms and legs. Often the rhythmic movements slow before stopping.
  • Eyes are generally open.
  • The person may not appear to be breathing. The person is often breathing deeply after an episode.
  • The return to consciousness is gradual and should occur within a few moments.
  • Loss of urine is common.
  • Often people will be confused briefly after a generalized seizure

Diagnosing Epilepsy

The evaluation of patients with epilepsy is aimed at determining the type of seizures (epileptic versus nonepileptic) and their cause, since various seizure types respond best to specific treatments.

The epilepsy diagnosis is based on:

  • The patient’s medical history, including any family history of seizures, associated medical conditions and current medications. Some important questions you will be asked include:
  • At what age did the seizures begin?
  • What circumstances surrounded your first seizure?
  • What factors seem to bring on the seizures?
  • What do you feel before, during, and after the seizures?
  • How long do the seizures last?
  • Have you been treated for epilepsy before?
  • What medications were prescribed and in what dosages?
  • Was the treatment effective?
  • Others who have often seen you before, during, and after seizures, such as family and close friends, should be present to provide details of your seizures if they involve loss of consciousness.
  • A complete physical and neurological exam of muscle strength, reflexes, eyesight, hearing, and ability to detect various sensations are tested so your doctors can better understand the cause of your seizures
  • An electroencephalogram (EEG) test, which measures electrical impulses in the brain*
  • Imaging studies of the brain, such as those provided by magnetic resonance imaging (MRI)
  • Blood tests to measure red and white blood cell counts, blood sugar, blood calcium, and electrolyte levels; and to evaluate liver and kidney function. Blood tests help rule out the presence of other illnesses.
  • Other tests, as needed, including magnetic resonance spectroscopy (MRS), positron emission tomography (PET) and single photon emission computed tomography (SPECT

How is Epilepsy Treated?

The majority of epileptic seizures are controlled through drug therapy. Diet may also be used along with medications.

In certain cases in which medications and diet are not working, surgery may be used. The type of treatment prescribed will depend on several factors including the frequency and severity of the seizures as well as the person’s age, overall health, and medical history.

An accurate diagnosis of the type of epilepsy is also critical to choosing the best treatment.