A Visual Guide to Epilepsy

What Is Epilepsy?

It's a problem with your brain’s electrical system. A surge of electrical impulses cause brief changes in movement, behavior, feeling, or awareness. These events, known as seizures, last from a few seconds to a few minutes. People who've had two or more seizures without obvious triggers at least 24 hours apart have epilepsy.

What Are the Symptoms?

Epilepsy can cause convulsions -- sudden, uncontrolled movements. But seizures can trigger a wide range of other symptoms, from staring to falling to fumbling with clothes. Most doctors divide them into different types according to how they affect your brain. Each has its own set of symptoms.

Absence Seizures

These are often described as staring spells. The person stops what he’s doing, stares into space for a few seconds, then goes on like nothing happened. It’s most common in children and usually starts between the ages of 4 and 12. Some kids have as many as 100 absence seizures in 1 day.

Generalized Tonic-Clonic Seizures

These used to be called grand mal seizures, and they’re the most easily spotted. Your arms and legs stiffen, then begin to jerk. This can last up to 3 minutes. After it happens, you’ll probably be tired and confused. This type of seizure involves both sides of the brain.

Partial Seizures

These only affect one side of your brain. You might make jerking motions or see things that aren’t there, but still be aware of what’s happening. If you have a complex partial seizure, you might wander, mumble, smack your lips, or fumble with your clothes. Others might think you’re conscious, but you won’t be aware of what you’re doing.

What Causes Epilepsy?

Anything that disrupts the brain’s natural circuitry can bring on this disorder:

• Genes
• A change in the structure of your brain
• Severe head injury
• Brain infection or disease
• Stroke
• Lack of oxygen

Most people with epilepsy never find a specific cause.

Do Kids Get Epilepsy?

Yes, but some outgrow it in a few years. Regular medication often stops it. If drugs alone don't keep it under control, other treatments may help. A well-informed school staff can help a child with epilepsy safely take part in most activities.

Diagnosis: EEG

A doctor will review the description of your seizures and your medical history, then examine you. He’ll give you a test called an electroencephalogram -- he’ll probably shorten it to EEG -- to confirm a diagnosis and get more information about your seizures. It’s a painless procedure that records your brain’s electrical activity as wavy lines. The pattern changes during a seizure and may show which part of the brain is affected. That can help guide your treatment.

Diagnosis: Brain Scan

Detailed images of your brain from tests like CT or MRI scans can help doctors rule out some things as causes, like a change in the structure of your brain, bleeding, or masses. A CT scan is a powerful type of X-ray, and an MRI uses magnets and radio waves to make pictures. This information will help your doctor come up with the best treatment plan for you.

Epilepsy Complications

The best way to avoid them is to find a treatment that helps you, and stick with it. Most people with the brain disorder live a long time, and they're rarely injured during seizures. But if you fall during them, you may need a helmet to protect your head. Some types of seizures may raise the risk of an early death, but this is rare.

Safety Measures

Because seizures often strike without warning, some activities are dangerous. Losing consciousness while swimming or taking a bath could be life-threatening. The same goes for many extreme sports, like mountain climbing. Most states require you to be seizure-free for a certain amount of time before driving a car.

Treatment: Medication

Anti-seizure drugs are the most common epilepsy treatment. If a medication doesn’t work, your doctor may adjust the dose or switch you to a different drug. About two-thirds of people with the brain disorder become seizure-free by taking their meds as prescribed.

Treatment: Ketogenic Diet

If medications don't help you or cause side effects, a doctor may suggest this eating plan. It's strict, and your medical team will watch you closely while you do it. The diet is high in fat and protein, and low in carbs -- a mix that makes your body burn fat instead of sugar. This creates changes in your brain that help lower your chances of seizures. More than half of children who follow this diet have at least 50% less seizures. Some even stop having them.

Treatment: VNS

It stands for vagus nerve stimulation, a treatment that’s sometimes called a pacemaker for your brain. The doctor places a small device under the skin of your chest. It sends electrical pulses to the brain through a large nerve in your neck called the vagus nerve. VNS may be an option if you don't do well with medication.

Treatment: Surgery

It can stop partial seizures. If the medical team finds that yours always begin in a single area of your brain, removing that area may stop them or make them easier to manage. Surgery also treats conditions that cause  seizures, like a brain tumor.

First Aid for Seizures

If you see someone having a seizure, take the following steps:

• Time how long it lasts.
• Clear the area of anything hard or sharp.
• Loosen anything at the neck that may affect her breathing.
• Turn her onto her side.
• Put something soft beneath her head.
• Don't place anything inside the mouth.

Call 911 if a seizure lasts more than 5 minutes, happens again, or the person is pregnant, injured, or has diabetes.

Treatment for Status Seizures

Long-lasting or recurring seizures may be a condition called status epilepticus. It can cause serious problems and needs emergency treatment. To bring the seizures to an end quickly, hospitals often give drugs by IV, along with oxygen.

Epilepsy and Pregnancy

It’s safe for most women with the brain disorder to get pregnant. More than 90% of babies born to moms with epilepsy are healthy. But if you're planning to have a child, talk to your doctor first. Anti-seizure drugs can cause health problems in infants. Your medicine or its dose may need to be changed.

Seizure Dogs

Service dogs can be trained to behave a certain way during a seizure. For example, the animal can lie next to the person to help prevent an injury. A dog can be trained to alert the parents during a child’s seizure.

Epilepsy Research

Doctors are looking for new treatments with two goals:

• Help more people fully control their seizures.
• Reduce treatment side effects.

Some researchers are also studying implantable devices that could alert you when a seizure is about to happen.

Living With Epilepsy

You can enjoy a full, active life. Taking your medication on schedule may stop your seizures. If not, you can get other kinds of help. A specialist can come up with ways to curb the condition's impact on your life. The American Academy of Neurology and the Epilepsy Foundation have listings of neurologists who specialize in treating it, too.