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Epilepsy is a common condition that causes repeated seizures. The seizures are caused by bursts of electrical activity in the brain that aren't normal. Seizures may cause problems with muscle control, movement, speech, vision, or awareness. In most cases, they don't last very long. But they can be scary. The good news is that treatment usually works to control and reduce seizures.
Epilepsy is not a type of mental illness or intellectual disability.
Seizures may look scary or strange. But they don't make a person crazy, violent, or dangerous. You can't catch epilepsy from other people (like you can catch a cold), and they can't catch it from you.
Many things can cause epilepsy. It may develop as a result of a head injury or a condition that causes damage to the brain, like a tumour or stroke. Genes may also play a role. But you don't have to have a family history to develop it. Often doctors don't know what causes epilepsy.
The main symptom of epilepsy is repeated seizures. There are different kinds of seizures. You may notice strange smells or sounds. You may lose control of your muscles. Or your body may twitch or jerk. Your symptoms will depend on the type of seizure you have.
Diagnosing epilepsy can be hard. Your doctor will ask questions to find out what happened just before, during, and right after a seizure. Your doctor will examine you. You'll have some tests, such as an electroencephalogram. This information can help your doctor decide what kind of seizures you have and if you have epilepsy.
You can take medicines to control and reduce seizures. Which type you use depends on the type of seizure. You and your doctor will need to find the right combination, schedule, and dose of medicine. If medicine alone doesn't help, your doctor may suggest a special diet or surgery to help reduce seizures.
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The risk for epilepsy increases if you have:
Epilepsy may develop even though you do not have any risk factors. This is especially true of many forms of childhood epilepsy.
The main symptom of epilepsy is repeated seizures. Without treatment, seizures may continue and become worse and happen more often over time.
There are different kinds of seizures. You may have only one type of seizure. Some people have more than one type. Depending on what kind of seizure you have:
Not everyone who has seizures has epilepsy. Sometimes seizures happen because of an injury, an illness, or another problem. In these cases, the seizures stop when that problem improves or goes away.
There are many types of epilepsy. All types cause seizures. Some specific types are:
Epilepsy does not always follow a course that you can predict. It can start at any age. And it may get worse over time or it may get better.
Though not common, epilepsy that begins in a certain area of the brain may over time affect another part of the brain. Some types of childhood epilepsy go away after the child reaches the teen years. Other types may continue for life. Epilepsy that started after a head injury may go away after several years or may last the rest of your life.
Epilepsy that causes focal seizures is sometimes called focal epilepsy, because the seizures start at a specific focus or location within the brain. In people with this type of disorder, the electrical charges that cause seizures begin in a specific area in the brain, although more of the brain may become affected during the seizure.
Epilepsy that causes focal seizures is the most common type of epilepsy in adults.
Epilepsy that causes generalized seizures is more common in children than in adults. Focal seizures start in a specific, often damaged area in the brain. But generalized seizures can't be traced to a specific location or focus. The abnormal electrical activity that causes the seizures begins over the entire surface of the brain. And these seizures tend to affect the entire body.
Sometimes the cause of this type of seizure is not known. In some cases, it may be caused by another condition like an infection or head injury. It is most often treated with medicine. But surgery may help in some cases.
Epileptic seizures themselves usually cause no harm. The danger lies in where you are or what you are doing when the seizure occurs. For example, there is a risk of head injury, broken bones, and other injuries when you fall during a seizure.
Some seizures may place brief but severe stress on the body. This can cause problems with the muscles, lungs, or heart. Choking or an abnormal heartbeat may cause sudden death, though this is rare. Seizures that aren't treated and become more severe or frequent may lead to these problems.
More serious problems related to epilepsy are not common but may include:
Call 911 or other emergency services immediately if:
Call your doctor now if you have a seizure for the first time.
If you have been diagnosed with epilepsy, call your doctor if:
Watchful waiting is okay if you have already been diagnosed with epilepsy and you have a seizure. But call your doctor right away if you have a second seizure within a short period of time or if your seizures have become more frequent or more severe. Your doctor may need to change the amount of medicine you take or try a different medicine.
If you know someone who has epilepsy, learn what to do when the person has a seizure .
It can be hard to diagnose epilepsy. A physical exam and your detailed medical history often give the best clues as to whether you have epilepsy and what type of epilepsy and seizures you have.
If you think that you've had a seizure, your doctor will first try to figure out if it was a seizure or something else with similar symptoms. For example, a muscle tic or a migraine headache may look or feel like a kind of seizure.
Your doctor will ask lots of questions to find out what happened to you just before, during, and right after a seizure. Your doctor will also check you and do some tests, such as an electroencephalogram (EEG). This information can help your doctor decide what kind of seizures you have and if you have epilepsy.
You can take medicines to control and reduce seizures. You and your doctor will need to find the right combination, schedule, and dose of medicine. After you find a medicine that works for you, take it exactly as prescribed.
If medicine alone doesn't control your seizures, your doctor may recommend other treatments. They include:
To help control your seizures, follow your treatment plan. If you take medicine to control seizures, take it exactly as prescribed.
The medicine works best if you take the right amount on the schedule your doctor sets up. Following this schedule keeps the right level of medicine in your body. Even missing just a few doses can allow seizures to happen.
You might be on a special ketogenic diet. If so, follow the diet carefully.
As you follow your treatment plan, also try to figure out and avoid things that may make you more likely to have a seizure. These may include:
If you keep having seizures despite treatment, keep a record of them. Note the date, time of day, and any details about the seizure that you can remember. Your doctor can use this information to plan or adjust your medicine or other treatment. The record can also help your doctor find out what kinds of seizures you are having.
If you have epilepsy:
There are many medicines used to treat epilepsy. These are called antiepileptics. You may also hear them called anticonvulsants or antiseizure medicines. But they don't all treat the same types of seizures. So the first step is for your doctor to figure out the types of seizures you have.
It may take time and careful, controlled adjustments by you and your doctor to find the combination, schedule, and dose of medicine to best manage your epilepsy. The goal is to prevent seizures while causing the fewest side effects.
Some antiepileptics are used alone. And some are used only along with other medicines.
If you haven't had a seizure in several years, you may ask your doctor if you can slowly stop or reduce your medicine. You and your doctor will need to weigh the benefits of stopping treatment against the risk that your seizures may return.
You have a lower risk of having a seizure after you stop medicine if:
When the body burns (metabolizes) fat, it creates substances called ketones. The ketogenic diet tries to force the body to use more fat for energy instead of sugar (glucose) by increasing fat and restricting carbohydrates. The ketogenic diet can be used to prevent seizures in a child who has any type of epilepsy. It is not yet clear how or why the ketogenic diet prevents or reduces seizures.
One version of the ketogenic diet provides 4 grams of fat for every 1 gram of protein and carbohydrate together. People on a ketogenic diet have to eat mostly fatty foods, such as butter, cream, and peanut butter. Foods such as bread, pasta, fruits, and vegetables have to be severely limited. And the person's total calories are also restricted. At every meal, the food has to be measured carefully so that the right amounts of each food are given. Even a slight departure from the diet can cancel its effect.
If you are thinking about the ketogenic diet, keep in mind:
The ketogenic diet is very strict and can be hard for some people and families to follow. Other special diets for epilepsy that are less strict may also be tried.
People on this diet take an oil supplement instead of relying on food for the fat in the diet. This can make the diet easier, because less total fat is needed from food and the person can eat more protein and carbohydrates.
The Atkins diet is known as a high-protein, low-carbohydrate diet. The modified Atkins diet for people with epilepsy is similar to the ketogenic diet but allows for a little more flexibility in protein, fluid, and calorie amounts.
This is the least restrictive special diet for epilepsy. It does not restrict fluids or protein and people do not need to be so strict about calories or the amount of fat they eat. People on this diet still eat much more fat than in a typical diet, but carbohydrates are not as limited.
Adaptation Date: 9/18/2023
Adapted By: Alberta Health Services
Adaptation Reviewed By: Alberta Health Services
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