WHAT IS EPILEPSY?

WHAT ARE THE DIFFERENT TYPES OF SEIZURES?

There are many different types of seizures. The kind of seizure a person has depends on which part of the brain is affected by the electrical disturbance that produces seizures. Experts divide seizures into generalized seizures (absence, atonic, tonic-clonic, myoclonic), partial (simple and complex) seizures, nonepileptic seizures, febrile seizures and status epilepticus.

WHAT ARE NON-EPILEPTIC EVENTS?

Many neurological and psychiatric conditions, as well as normal behaviors in infants and children, can mimic a seizure. These episodes are referred to as non-epileptic events. Among the most common are events associated with emotional difficulties, fainting spells, sleep disorders, breath holding spells, gastrointestinal reflux, and movement disorders.

WHAT ARE FEBRILE SEIZURES?

Febrile (fever-caused) seizures or convulsions affect many children between the ages of 3 months and 6 years. Febrile seizures are not the same as epilepsy. Most children grow out of febrile seizures as they grow older and develop normally. Relatively few will go on to develop epilepsy.

WHAT CAUSES EPILEPSY?

There are different reasons a person develops epilepsy. Broadly, epilepsy can be caused by a structural abnormality in the brain tissue, or abnormalities in the "wiring" of brain electricity. Examples of structural abnormalities include epilepsy that occurs after strokes, brain tumors, brain injury, and brain infections. In many patients, there is no obvious cause for epilepsy.

WHAT IS VIDEO-EEG MONITORING?

Video EEG (link) is a special procedure that is usually utilized to achieve the most accurate and specific information about patient's seizures. Patients are admitted to a room in the hospital that has been specially equipped for this test. The doctors, nurses, and technicians who are involved in this test are highly trained in diagnosing and treating seizures. Electrodes are applied to the patient's head as in a routine EEG. Data from these electrodes is obtained continuously while cameras positioned in the room record all of the patient's actions. In the event of a seizure, the electrical activity of the brain during the episode can be accurately analyzed and correlated to observed clinical manifestations.

What are treatment options if Medications do not work?

Occasionally, a patient will not respond to medication and will continue to have epileptic seizures, despite treatment with various appropriate medications. For those patients several options still exist to achieve seizure control. These options include special diets such as the ketogenic diet, device therapy such as the vagus nerve stimulator, and epilepsy surgery.

WHAT IS A SEIZURE?

A seizure happens when the electrical system of the brain malfunctions. Instead of controlled electrical energy in the brain cells, the brain cells keep firing, resulting in a variety of clinical manifestations depending on which area or areas of the brain is involved in the seizure.

WHAT IS A EPILEPSY?

Epilepsy is a neurological condition characterized by recurrent seizures. The word "epilepsy" does not indicate anything about the cause of the person's seizures, what type they are, or how severe they are.

WHAT ARE SYMPTOMS OF SEIZURES?

Seizures can take on many different forms and can affect different people in different ways. Some common symptoms during a seizure include alteration of the level of awareness, lip smacking, confusion, abnormal movements and sensations, blank staring, shaking, behavioral changes, and the inability to talk. In the most severe form patients exhibit generalized body convulsions. Patients may also have a warning before a seizure, called an aura, such as the perception of a strange taste or smell, fear, anxiety, visual changes, stomach or epigastria discomfort, strange feelings, and dizziness. Patients may also have a combination of the above symptoms.

HOW IS EPILEPSY DIAGNOSED?

A careful and detailed medical history with as much information as possible about what the person does during a seizure including any aura or any after effects is paramount in the diagnosis. Another tool is an electroencephalograph (EEG). This is a machine that records brain waves picked up by tiny wires called electrodes taped to the head. Brain waves during or between seizures may show special patterns which help the doctor decide whether or not someone has epilepsy. Multiple techniques in structural and functional brain imaging may help point to the etiology of epilepsy.

HOW IS EPILEPSY TREATED?

Most patients with epilepsy will achieve seizure control by the use of appropriate anti-seizure medication. Each type of epilepsy responds differently to these medications. A specific seizure type may respond dramatically to one medication, while another medication may have no effect on that particular seizure type. People who have more than one type of seizure may need to take more than one kind of drug, although doctors try to control seizures with one drug if possible.

What Is an Epileptologist?

An epileptologist is a neurologist who specializes in the treatment of epilepsy.
A neurologist becomes an epileptologist typically after perusing comprehensive fellowship training at an Academic Epilepsy Center

Epileptologists are experts in seizures and seizure disorders, anticonvulsants, and special situations involving seizures, such as cases in which all treatment intended to stop seizures has failed. Epileptologists are directly involved in clinical and basic research to enhance understanding and management of epilepsy.

Finally, an Epileptologist is concerned about the non-medical issues of Epilepsy (social injustice, driving regulations, access to employment and healthcare, quality of life).