Seizures and epilepsy

Epilepsy is a condition that occurs in about one out of every 200 people. It is marked by recurrent convulsions—that is, sudden, temporary, uncontrollable losses or changes of consciousness. Convulsions may also be called epileptic seizures, fits, spells, or attacks. Whatever you call it, it is the result of abnormal electrical activity in the brain, and may be caused by injury to the brain or it may be inherited. Once seizures are controlled by medication, epileptics can usually do just about everything that people without epilepsy can do, including driving a car. Epilepsy is not contagious.

Epilepsy is usually diagnosed from a person’s medical history, plus other tests—usually an

electroencephalogram (EEG) and blood testing. In most patients an MRI is alsonecessary.

Epileptic symptoms take many forms, but there are a few major types of seizure, including grand

mal seizures, petit mal seizures, and partial seizures. The grand mal seizure, or major motor

attack, is the most severe. A person with epilepsy may recognize a warning signal, such as by a

certain familiar feeling in the stomach or by an involuntary jerking motion in the hand or foot. The

person will usually stiffen and fall down. He or she may also briefly stop breathing and become blue

from lack of oxygen. Next, the person’s body will begin jerking. A seizure usually ends within 60

seconds but may last several minutes. After the attack, the person is confused and often falls

asleep. While a grand mal seizure is frightening to witnesses, the person is rarely hurt seriously. If

you witness a seizure, the best thing you can do is help prevent injury to the person. Loosen tight

clothing and turn the person onto his or her side, not onto the back. Despite what you may have

heard, do not place anything in the person’s mouth. If the jerking lasts more than five minutes, or if

the person has two or more seizures without a return to consciousness in between, call 911 for

emergency medical treatment and request an ambulance to transport the patient to the nearest

Emergency Room.

Petit mal seizures, also called absence seizures, usually start at around grade school age. They

commonly result in a brief lapse of consciousness with only slight facial twitching or fluttering of the

eyes. Sometimes the child just seems to be daydreaming. However, an epileptic child can

sometimes have more than 100 of these seizures during a day, which can seriously interfere with

learning.

A third type of seizure is the partial seizure. A partial seizure is considered to be either simple or

complex, and involves involuntary movements without a complete loss of consciousness.

The simple partial seizure, also called a focal motor seizure, can involve twitching of the face,

hand, or leg on one side of the body. The person’s consciousness and memory usually remain

normal during simple partial seizures.

During a complex partial seizure, also called a psychomotor seizure, a person may look dazed,

confused, or puzzled. They may smack their lips, make sucking, drooling, or swallowing

movements, or pick at their clothing. This type of seizure may also include automatic behaviors

that appear normal, yet the person cannot respond appropriately to questions. The attacks last for

several minutes. After a complex partial seizure, the person is usually confused and cannot

remember anything about the episode.

In most cases, epilepsy can be well controlled by medication. Determining exactly the right

medication takes time because each person reacts differently to antiepileptic drugs. But in most

cases, once the right medication is established, all or nearly all seizures can be prevented—as

long as the medication is taken exactly as prescribed. The most common reason for treatment to

fail is that the epileptic person or a family member has changed or stopped the medication. With

the right medication, properly taken, most people with epilepsy can lead normal lives. Occasionally,

seizures can not be completely controlled with medication and other forms of treatment are

needed. If you’ve been diagnosed with epilepsy, you should take your medications exactly as

prescribed and avoid drinking alcohol. If you experience a seizure, or have bothersome

side-effects, call your health care professional. Your medications may need to be adjusted.

For patients uncontrolled with medications, other treatments such as brain surgery or Vagus Nerve

stimulator surgery may be needed.

Women and Epilepsy

Epilepsy Foundation

Epilepsy Foundation of Northern California

American Epilepsy Society