Epilepsy: Symptoms, Causes, Management & Risks Factors

Epilepsy is a neurological disorder characterized by sudden, recurrent and unprovoked uncontrolled movements of the body caused by an electrical disturbance in the brain. These seizures are caused by abnormal electrical activity in the brain that can result in a variety of physical and mental symptoms. Epilepsy can affect people of all ages and can range from mild to severe. With proper diagnosis and management, many people living with epilepsy can lead full and productive lives. Please keep reading for details on the following topics:

Risks factors of epilepsy

Causes of epilepsy

Symptoms of epilepsy

How people feel after a seizure

How a seizure is diagnosed

Precaution for persons with epilepsy

Complications of epilepsy

When to seek urgent medical care

How epilepsy is managed

What can persons present during the seizure do

SYMPTOMS OF EPILEPSY

During a seizure, various symptoms can occur depending on the type of seizure and the area of the brain affected. Common features of seizures include:

Uncontrollable muscle spasms: Rapid and repetitive contractions and relaxations of muscles throughout the body, known as convulsions or twitching.
Loss of consciousness: Some seizures may cause a person to lose awareness of their surroundings or become unresponsive.
Falling: If the seizure causes loss of muscle control, the person may collapse or fall to the ground.
Clenching of the teeth: Jaw muscles may tighten, leading to clenching or grinding of the teeth.
Biting of the tongue or cheek: Due to involuntary muscle contractions, the person may accidentally bite their tongue or inner cheek.
Foaming at the mouth: Increased saliva production during a seizure may result in foaming or frothing at the mouth.
Loss of bladder and/or bowel control: Involuntary release of urine or feces may occur during some seizures.
Episodes of staring blankly: Some seizures may involve brief periods of staring into space or appearing to be unaware of their surroundings.
Stiff muscles: Muscles may become rigid or tense during certain types of seizures.
Rapid blinking or twitching of the eyes: Eye movements may become rapid or twitchy during certain types of seizures.
Inability to speak: Some seizures may impair the person’s ability to communicate verbally.
Aura – warning signs that a seizure is about to occur, such as euphoria or unusual sensations.

HOW PEOPLE FEEL AFTER A SEIZURE

After a seizure, people may experience a range of physical and emotional sensations. Some common feelings and experiences include:

Headache: Many individuals report feeling a headache after a seizure, which can range from mild to severe.
Extreme tiredness: Seizures can be physically and mentally exhausting, leading to feelings of extreme fatigue and lethargy.
Amnesia: Some people may experience memory loss or gaps in memory surrounding the seizure event, known as transient global amnesia.
Unusual sensations: It’s not uncommon for individuals to experience unusual sensations or perceptions after a seizure, such as tingling, numbness, or heightened sensitivity to stimuli.
Feeling confused, disoriented, or dazed: Seizures can disrupt cognitive function, leading to feelings of confusion or disorientation after the event.
Lapses in memory: Memory lapses or difficulties recalling events before, during, or after the seizure are common.
Fear and anxiety: Seizures can be frightening experiences, and individuals may feel anxious or fearful following an episode.
Deep sleep: Some individuals may feel an overwhelming urge to sleep or experience prolonged periods of deep sleep after a seizure, known as postictal sleep.
Muscle soreness, weakness, or pain: Due to the intense muscle activity during a seizure, individuals may experience muscle soreness, weakness, or pain afterward.

These post-seizure symptoms and experiences can vary widely among individuals and may depend on factors such as the type and severity of the seizure, the person’s overall health, and their individual sensitivity to seizure activity.

CAUSES OF EPILEPSY

Epilepsy can have various causes, and often the exact cause is not clear. Some common factors and conditions associated with the development of epilepsy include:

Abnormal brain activity: Epilepsy is primarily a disorder of abnormal electrical activity in the brain. This can be due to various factors, including changes in brain structure or function.
Genetic predisposition: There may be a genetic component to epilepsy, as certain genetic factors can increase the risk of developing the condition. Individuals with a family history of epilepsy may have a higher likelihood of developing it themselves.
Head injury: Traumatic brain injuries resulting from accidents, falls, or other incidents can lead to changes in brain function that increase the risk of seizures and epilepsy.
Illness affecting the brain: Certain illnesses or conditions that affect the structure or function of the brain, such as stroke, brain tumors, infections (such as meningitis or encephalitis), or neurodegenerative diseases, can increase the risk of epilepsy.
Brain injury: Any injury or trauma to the brain, including birth injuries, may lead to epilepsy, particularly if the injury affects areas of the brain involved in regulating electrical activity.
Birth defects: Some congenital conditions or developmental abnormalities of the brain present at birth may predispose individuals to epilepsy.
High fever: Febrile seizures, which occur in young children during episodes of high fever, may increase the risk of developing epilepsy later in life, although not all febrile seizures lead to epilepsy.
Environmental factors: Certain environmental factors, such as exposure to toxins, infectious agents, or prenatal exposure to substances like alcohol or drugs, may contribute to the development of epilepsy.
Flashing lights: In some cases, specific visual stimuli, such as flashing lights or patterns, can trigger seizures in susceptible individuals, a condition known as photosensitive epilepsy.
Metabolic disorders: Certain metabolic disorders or imbalances, such as low blood sugar (hypoglycemia), may increase the risk of seizures and epilepsy.
Use of illegal drugs: Substance abuse, including the use of illicit drugs such as cocaine, amphetamines, or heroin, can increase the risk of seizures and may lead to the development of epilepsy, particularly if used chronically or in high doses.
Withdrawal from alcohol or drugs: Abrupt discontinuation of certain substances, such as alcohol, benzodiazepines, or certain medications, can trigger withdrawal seizures in susceptible individuals. Prolonged substance abuse can also lead to changes in brain function that increase the risk of epilepsy.
COVID-19 virus infection: Emerging evidence suggests that infection with the SARS-CoV-2 virus, which causes COVID-19, may be associated with an increased risk of neurological complications, including seizures and epilepsy. While the mechanisms underlying this association are still being studied, it’s believed that the virus may directly affect the central nervous system or trigger inflammatory responses that lead to seizures in some individuals.

PRECAUTION FOR PERSONS WITH EPILEPSY

Precautions for individuals with epilepsy are crucial to help manage the condition and reduce the risk of seizures. Here are some important precautions:

Follow a healthy and nutritious diet: Eating a balanced diet can help maintain overall health and may have a positive impact on seizure control for some individuals.
Have a regular exercise regimen: Regular physical activity, as long as it’s safe and appropriate for the individual, can help reduce stress and improve overall well-being. However, activities with a high risk of injury or exhaustion should be avoided.
Learn to manage stress effectively: Stress can sometimes trigger seizures in some individuals. Learning stress management techniques such as deep breathing, meditation, or mindfulness may help reduce stress levels.
Get adequate rest: Ensuring sufficient sleep and maintaining a regular sleep schedule can be important for seizure management. Fatigue and lack of sleep can sometimes trigger seizures in some individuals.
Avoid tobacco and alcohol use: Smoking and excessive alcohol consumption can have negative effects on overall health and may also affect seizure control. Avoiding tobacco and limiting alcohol intake is advisable.
Wear seatbelts and helmets when riding vehicles: Taking appropriate safety precautions, such as wearing seatbelts in cars and helmets while cycling or participating in other activities, can help prevent injuries during seizures or accidents that may trigger seizures.
Pregnant women must follow proper prenatal care: Pregnant women with epilepsy should work closely with their healthcare providers to manage their condition during pregnancy. Proper prenatal care, including regular check-ups and medication management, is essential to ensure the health of both the mother and the baby.
Take medication as prescribed: For individuals with epilepsy who require medication to control seizures, it’s important to take prescribed medications consistently and as directed by a healthcare provider. Skipping doses or abruptly discontinuing medication can increase the risk of seizures.
Avoid triggers: Identify and avoid specific triggers that may increase the risk of seizures, such as flashing lights, certain medications, or stressors, whenever possible.
Create a safe environment: Minimize risks in the home by removing sharp objects, securing furniture, and taking other precautions to prevent injury during seizures. Consider using safety devices such as bed rails or seizure alert devices if appropriate.

COMPLICATIONS OF EPILEPSY

Complications of epilepsy can significantly impact the lives of individuals with the condition. Here are some potential complications:

Injuries or death due to falls: Seizures can cause sudden loss of muscle control, leading to falls and injuries. In severe cases, falls can result in fractures, head injuries, or even death.
Drowning during swimming: Seizures occurring during swimming or other water-related activities can pose a risk of drowning if the person loses consciousness or control.
Increased risk of accidents when driving a vehicle: Seizures can impair consciousness and motor control, increasing the risk of accidents while driving or operating machinery.
Complications during pregnancy: Epilepsy can present challenges during pregnancy, including increased risk of seizures, potential effects of antiseizure medications on the developing fetus, and the need for careful management to ensure the health of both the mother and the baby.
Status epilepticus: Some individuals may experience prolonged or recurrent seizures without regaining consciousness, a condition known as status epilepticus, which can be life-threatening if not promptly treated.
Sudden unexpected death in epilepsy (SUDEP): In rare cases, epilepsy may be associated with sudden, unexplained death, particularly during or after seizures. The exact cause of SUDEP is not fully understood, but it underscores the importance of seizure management and monitoring.
Falling, causing injury to the head or bones: Seizures can lead to sudden falls, increasing the risk of head injuries, fractures, or other orthopedic injuries.
Drowning in one’s own secretions: Seizures can sometimes affect breathing or swallowing, leading to an increased risk of inhaling saliva or secretions, which can cause respiratory problems or aspiration pneumonia.
Car accidents associated with loss of awareness: Seizures that cause loss of awareness or consciousness can result in accidents while driving or operating machinery, posing a risk to both the individual and others.
Pregnancy complications such as birth defects: Some antiseizure medications used to manage epilepsy may pose risks to the developing fetus, potentially leading to birth defects or other pregnancy complications.
Emotional health issues: Living with epilepsy can be challenging and may lead to emotional health issues such as depression, anxiety, or social stigma, which can affect overall well-being and quality of life.

HOW A SEIZURE IS DIAGNOSED

Diagnosing a seizure typically involves a comprehensive evaluation by a healthcare professional to determine the underlying cause and nature of the seizure. Here are the steps involved in diagnosing a seizure:

Medical history: The healthcare provider will begin by taking a detailed medical history, including information about the person’s symptoms, previous medical conditions, family history of seizures or neurological disorders, and any potential triggers or events preceding the seizure.
Physical examination: A thorough physical examination will be conducted to assess neurological function, including tests of reflexes, coordination, muscle strength, and sensation.
Diagnostic tests: Several diagnostic tests may be ordered to help confirm the diagnosis of a seizure and identify any underlying causes. These tests may include:
- Electroencephalogram (EEG): An EEG is a test that records the electrical activity of the brain. It can help identify abnormal patterns of brain waves characteristic of seizures and determine the type of seizure activity.
- Imaging studies: Imaging tests such as magnetic resonance imaging (MRI) or computed tomography (CT) scans may be performed to visualize the structure of the brain and identify any abnormalities, such as tumors, scars, or structural changes, that may be causing seizures.
- Blood tests: Blood tests may be done to check for signs of infection, metabolic disorders, or other medical conditions that could be contributing to seizures.
- Lumbar puncture (spinal tap): In some cases, a lumbar puncture may be performed to collect cerebrospinal fluid for analysis if there is suspicion of infection or inflammation affecting the brain and spinal cord.
- Other tests: Additional tests, such as neuropsychological testing or genetic testing, may be ordered based on clinical findings and suspected underlying causes.
Seizure classification: Based on the clinical history, EEG findings, and other diagnostic tests, the healthcare provider will classify the type of seizure and determine whether it is epileptic or non-epileptic in nature.
Evaluation of underlying causes: Once a seizure diagnosis is confirmed, efforts will be made to identify any underlying medical conditions or triggers that may be contributing to seizures. This may involve further evaluation and management by specialists, such as neurologists, epileptologists, or other healthcare professionals.
Monitoring and follow-up: Individuals diagnosed with seizures will require ongoing monitoring and follow-up to assess treatment effectiveness, adjust medications as needed, monitor for side effects, and address any new or worsening symptoms.

HOW EPILEPSY IS MANAGED

Managing epilepsy involves various strategies aimed at controlling seizures, minimizing their impact on daily life, and addressing any associated medical or psychosocial issues. Through proper management, those with epilepsy can live a healthy and productive life. Here are key components of epilepsy management:

Elimination of the cause: Identifying and addressing any underlying causes or triggers of seizures, such as brain tumors, infections, or metabolic disorders, is an essential part of epilepsy management.
Medications to control seizures: Antiseizure medications (also called antiepileptic drugs or AEDs) are typically the first-line treatment for epilepsy. These medications work by stabilizing electrical activity in the brain and preventing or reducing the frequency and severity of seizures. The choice of medication depends on factors such as the type of seizures, age, overall health, and potential side effects.
Lifestyle adjustments: Making lifestyle modifications can help reduce the frequency and severity of seizures. This may include getting adequate sleep, avoiding known triggers (such as flashing lights or certain medications), managing stress, and maintaining a healthy diet and regular exercise routine.
Avoidance of alcohol and recreational drugs: Alcohol and certain recreational drugs can lower seizure thresholds and increase the risk of seizures. Individuals with epilepsy should avoid or limit their consumption of alcohol and illicit drugs.
Surgical interventions: In some cases, surgery may be recommended to remove or disconnect the area of the brain responsible for seizures (epileptic focus). This procedure, known as epilepsy surgery, is considered for individuals whose seizures are not adequately controlled with medication and who are candidates for surgery based on comprehensive evaluation.
Vagus nerve stimulation (VNS): VNS is a treatment option for individuals with epilepsy who do not respond well to medications or who are not candidates for surgery. It involves implanting a device that delivers electrical impulses to the vagus nerve, which can help reduce the frequency and severity of seizures.
Ketogenic diet: The ketogenic diet is a high-fat, low-carbohydrate diet that has been shown to be effective in reducing seizures, particularly in children with epilepsy who have not responded well to medications. This diet should be supervised by healthcare professionals experienced in its implementation.
Emotional support and counseling: Living with epilepsy can have significant emotional and psychosocial impacts. It’s essential for individuals with epilepsy to have access to support networks, counseling, and resources to address any mental health issues, such as anxiety, depression, or social stigma.
Regular medical follow-up: Ongoing medical monitoring and follow-up are essential for individuals with epilepsy to assess treatment effectiveness, adjust medications as needed, monitor for side effects, and address any new or worsening symptoms.
Brain surgery for persons who continue to have seizures despite taking antiseizure medication: In cases where seizures persist despite medication, brain surgery may be an option to consider. Discuss this possibility with healthcare providers.

BYSTANDERS PRESENT DURING A SEIZURE CAN

Persons present during a seizure play a crucial role in providing assistance and ensuring the safety of the individual experiencing the seizure. Here are some actions they can take:

Protect the person from falling: If possible, guide the person gently to the ground to prevent injury from a fall. Place something soft under their head to cushion it.
Loosen the clothing around the neck: If the person’s clothing is tight around the neck, loosen it to ensure proper airflow.
Place a pillow or an item of clothing under the head: If the person is lying down, place a pillow, cushion, or folded clothing under their head to prevent head injury.
Roll the person over to one side: Turn the person onto their side to help maintain an open airway and prevent choking on saliva or vomit.
Avoid leaving a person alone during the seizure: Stay with the person until the seizure ends and they have fully recovered. Reassure them and offer support.
Call for help or alert a doctor: If the seizure lasts longer than usual, if the person is injured, if they have difficulty breathing or regaining consciousness, or if it’s their first seizure, seek medical assistance immediately.
Prescribed antiseizure medication can be administered: If the person has a prescribed rescue medication for seizures, such as rectal diazepam or buccal midazolam, and it is safe to do so, administer it according to the healthcare provider’s instructions.
Avoid restraining the person: Do not attempt to restrain the person’s movements during the seizure, as this can cause injury to both the person and the helper. Allow the seizure to run its course while ensuring the person’s safety. Avoid attempting to put an object (such as a spoon) in the person’s mouth during a seizure activity.
Keep all sharp or dangerous objects out of reach: Remove any nearby objects that could cause harm during the seizure, such as sharp or heavy items.
Ensure that the person is placed on a flat surface with the head tilted to one side: Position the person on their side to prevent choking and aspiration of saliva or vomit.

WHEN TO SEEK URGENT MEDICAL CARE

Seeking urgent medical care is crucial in certain situations for individuals with epilepsy. Here are circumstances that warrant immediate medical attention:

Seizure activity: If a seizure lasts longer than usual or if multiple seizures occur in succession without recovery in between, it may indicate a medical emergency.
Breathing or consciousness doesn’t return after the seizure stops: If the person does not regain consciousness or normal breathing patterns after a seizure, it’s essential to seek medical help immediately.
A second seizure follows immediately: If a person experiences another seizure immediately after the first one, it could be a sign of status epilepticus, a medical emergency requiring prompt intervention.
High fever: In young children, especially those with a history of febrile seizures, a high fever may trigger seizures and should be closely monitored. Seek medical attention if the fever is high or persistent.
Pregnancy: Pregnant women with epilepsy require specialized care to manage their condition and minimize risks to themselves and their baby. Any changes in seizure frequency or medication requirements during pregnancy should be promptly reported to healthcare providers.
Diabetes: Individuals with epilepsy who also have diabetes need careful management, as fluctuations in blood sugar levels can trigger seizures. Seek medical attention for any significant changes in blood sugar levels or symptoms of hypoglycemia.
Injured self during the seizure: If the person sustains injuries during a seizure, such as head trauma or fractures, immediate medical attention is necessary to assess and treat the injuries.
Experience a seizure for the first time: If someone experiences a seizure for the first time, it’s essential to seek medical evaluation to determine the underlying cause and establish a diagnosis.

It is important to know when to seek urgent medical care, as delaying appropriate treatment can lead to further health complications. If you have any doubts about whether you should seek medical care, it is always better to err on the side of caution and consult with your doctor.

Disclaimer: The information provided in this content is for general informational purposes only. It is not intended as medical or healthcare advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare professional with any questions you may have regarding a medical condition or healthcare decisions. epilepsy disorder epilepsy disorder epilepsy disorder epilepsy disorder epilepsy disorder epilepsy disorder epilepsy disorder epilepsy disorder