What is Epilepsy?
Epilepsy is a well-known condition that affects the brain and usually begins in childhood. It causes repeated seizures, which are also known as fits. Epilepsy is known to affect more than 500,000 people in the UK alone, meaning that 1% of people – or 1 in every 100 people - has the condition.
Research into epilepsy is ongoing, but what is known is that cells in the brain, known as neurones, communicate with each other using electrical impulses. When these electrical impulses are disrupted, the brain and body behave strangely and this may trigger what we know as a seizure. The extent and experience of seizures vary between individuals.
What Are the Symptoms of Epilepsy?
The main symptoms of epilepsy are seizures. Depending on which part of the brain is affected there are a number of different seizure types. These seizures can occur either when you are awake or asleep.
Doctors will classify seizures by how much of the brain is affected. Partial seizures occur when only a small part of the brain is affected while generalised seizures occur in instances where most or all of the brain is affected. Unclassified seizures do not fit into these categories.
In partial seizures it is possible to be fully conscious throughout (known as a simple partial seizure). A complex partial seizure means that all sense of awareness is lost and there will be no memory of the seizure afterwards.
Other symptoms of a partial seizure include
- An alteration in the way things smell, sound, taste, feel or look
- A strong sense of déjà vu
- Pins and needles in limbs or sudden stiffness
- Intense emotions – such as fear or joy
- Twitching on one side of the body
In complex partial seizures there may also be some strange and random bodily behaviour, such as smacking of lips, fiddling, swallowing, making random noises or rubbing your hands.
During a generalised seizure it is usual to be completely unconscious. Generalised seizures have six main types. These include:
Absences, also known as petit mal, are seizures which mainly affect children. These cause a loss of awareness of surroundings for approximately 20 seconds where the child will stare vacantly into space. This can occur several times a day.
Myoclonic jerks, where the arms, legs or upper body jerk or twitch. They last for a fraction of a second. They can occur alongside other types of generalised seizures.
Clonic seizures are similar to myoclonic jerks, but last for up to two minutes and are more likely to result in loss of consciousness.
Atonic seizure causes all muscles to suddenly relax, which can cause the sufferer to unexpectedly fall.
Tonic seizures cause all the muscles to become suddenly stiff and can again cause a loss of balance.
Tonic-clonic seizures, also known as grand mal, are the most common type of seizures. They cause stiffness followed by twitching of limbs. This results in a loss of consciousness and lasts between one and three minutes, sometimes longer. Lay people would consider a tonic-clonic seizure to be an epileptic fit.
A further symptom of epilepsy includes auras. Auras are a distinctive feeling or warning sign that a seizure is on its way, although these are generally thought to be simple partial seizures. Some common auras include:
- Déjà vu
- Noticing a strange smell or taste
- Everything seeming suddenly dreamlike
- Fear or anxiety or a general feeling of strangeness
The Causes of Epilepsy
In the majority of cases of epilepsy, a cause cannot be found. Any identifiable cause tends to be because of a known brain injury. Any damage to the brain that affects the neurons, electrical impulses or chemicals (neurotransmitters) can cause seizures.
Symptomatic epilepsy is where there is a known cause for a person's epilepsy, usually a head injury. The causes of symptomatic epilepsy can include: cerebral palsy, drugs and alcohol misuse, birth, defects, meningitis, strokes, head injuries or brain tumours.
Idiopathic epilepsy is epilepsy with no apparent cause and this occurs in approximately 60% of all cases. Some epilepsy may have a genetic cause, but research is still in its infancy.
Cryptogenic epilepsy, like idiopathic epilepsy, is a type of epilepsy where no apparent cause can be found, although there are strong indications that it may be the result of brain damage. Evidence that suggests a person has cryptogenic epilepsy will include the fact that they have learning difficulties or have developmental conditions, such as autistic spectrum disorder.
There are certain triggers for epilepsy although these vary between individuals. The most common can include:
- Lack of sleep
- Stress or anxiety
- Binge drinking or hangovers
- Drug taking
- A high temperature
- Flashing lights
Because so many people suffer at least one seizure during their lifetimes, epilepsy will be diagnosed after you have had more than one seizure. A neurologist takes a description of your seizures and any symptoms you have had, and may undertake scans in order to discover which areas of the brain are affected by epilepsy.
Your doctor will also want to know about your medical and personal history and your use of medicines, drugs or alcohol. Some doctors will use an electroencephalogram (EEG) in order to detect unusual brain activity associated with epilepsy, or magnetic resonance imaging (an MRI scan), which can spot any defects in the structure of your brain.
Treatment for Epilepsy
Unfortunately medication cannot yet cure epilepsy although anti-epileptic drugs (AEDs) are often used to successfully control seizures. In certain cases, surgery can be used to remove an affected area of the brain, or an electrical device can be installed that can help to control seizures.
Prolonged seizures are sometimes treated with diazepam, but where they cannot be controlled the patient needs to be transferred to hospital for close monitoring and high levels of sedation.
Living with Epilepsy
For epilepsy sufferers it is important to exercise regularly and eat well, avoiding alcohol and drug use as much as possible.
Image source: stylephotographs / 123RF Stock Photo