Epilepsy and Seizures

Last Updated: 02/24/17

Index

  1. Causes
  2. Diagnosis
  3. Possible Issues
  4. Treatments
  5. Type of Seizures and Symptoms
  6. Transportation
  7. Other Epilepsy Facts
  8. Sources

Epilepsy is a brain condition in which a person has repeated Seizures over time. Seizures are episodes of disturbed brain activity that cause changes in temporary attention or behavior. A person is considered Epileptic (to have Epilepsy); if more than one Seizure occurs.

Seizures are similar to Strokes, where:

  • damage to the brain on the left side of the brain can cause a seizure on the right side of the body
  • damage to the brain on the right side of the brain can cause a seizure on the left side of the body

1. Causes

Epilepsy occurs when permanent changes in the brain cause it to be too excitable or irritable. As a result, the brain sends out abnormal signals. This leads to repeated, unpredictable Seizures. A single Seizure that does not happen again is not Epilepsy.

Purple Day

NF2 Possibilities

The likely causes of Epilepsy for individuals with Neurofibromatosis Type 2 (NF2) include:

  1. Brain Tumor: Chances increase as tumor mass increases and causes pressure on brain matter
  2. Stroke or Transient Ischemic Attack (TIA): Abnormal blood vessel flow in the brain
  3. Brain Abscess: Infections (bacterial or fungal)
  4. Brain Tissue Damage:
  5. Medications: Medications including but not limited to any that might dramatically alter tumor size.

Non-NF2 Possibilities

Additional reasons for Epilepsy:

  • Traumatic brain injury
  • Dementia, such as Alzheimer disease
  • Infections: Meningitis, Encephalitis, and HIV/AIDS
  • Brain problems that are present at birth (congenital brain defect)
  • Brain injury that occurs during or near birth
  • Metabolism disorders present at birth (such as phenylketonuria)
  • Other illness that damages or destroys brain tissue

2. Diagnosis

While a regular Neurologist may be able to diagnose and prescribe medication for Epilepsy, an Epileptologists might be needed for additional tests to understand an individual's situation better and would be more knowledgeable about different epilepsy treatments.

At first occurrence of a Seizure it is not always known what actually happened and can be confused with symptoms of a Stroke, even if a Stroke can sometimes trigger Seizures. Brain scans and medical review need to be done to know what happened. Some of the tests that might be run include:

  • CT Scan
  • EEG. An EEG (electroencephalogram)
    People with epilepsy often have abnormal electrical activity seen on this test. This test might be done to determine the entire region of the brain damaged and causing Seizure activity.
  • Blood chemistry
  • Blood sugar
  • CBC (complete blood count)
  • Kidney function tests
  • Liver function tests
  • Lumbar puncture (spinal tap)
  • Tests for infectious diseases

3. Treatments

Epilepsy can be managed with different medications and sometimes requires surgery.

If seizures go away, an individual may be able to come off seizure medicine if they have been seizure free for 2 to 5 years. But, the length of time a person is seizure free before stopping medicine depends on many issues and is up to the doctor following an individuals situation to determine.

About 50 to 60%, will be seizure free after using the first seizure medication tried.

About 60 to 70% may get control of seizures after a number of years, but it might be unknown if it would mean complete control of both seizures and side effects.

4. Possible Issues

  1. Difficulty learning
  2. Permanent brain damage (stroke or other damage)
  3. Breathing in food or saliva into the lungs during a seizure, which can cause aspiration pneumonia
  4. Injury from falls, bumps, self-inflicted bites, driving or operating machinery during a seizure
    - For road safety, most states in the US restrict ability to drive for anyone who has had a Seizure. The duration is between 6 months and 2 years, but this also allows an individual access to different Free Travel Options.
  5. Side effects of medications: one side effect of all medications is an issue concerning pregnancy
    - Steps should be taken to guarantee pregnancy cannot occur while taking any medication for Epilepsy. Medications can cause birth defects if a child lives full term if a mother is taking medications. Talk to your doctor about Birth Control Options.
  6. If you are planning to become pregnant and taking medications for epilepsy, talk to your doctor.

5. Triggers

Many people with epilepsy have learned from experience that certain situations make them more likely to have seizures. These triggers do not typically cause seizures in the general population. In other words, one has to have epilepsy for these triggers to lower the threshold sufficiently such that an epileptic seizure results.

  • Specific time of day or night
  • Sleep deprivation - overtired, not sleeping well, not getting enough sleep
  • At times of fevers or other illnesses
  • Flashing bright lights or patterns
  • Alcohol or drug use
  • Stress
  • Associated with menstrual cycle (women) or other hormonal changes
  • Not eating well, low blood sugar
  • Specific foods, excess caffeine or other products that may aggravate seizures
  • Use of certain medications

6. Types of Seizures and Symptoms

Seizures are generally described in two major groups, Primary Generalized Seizures and Partial Seizures. Primary generalized seizures begin with a widespread electrical discharge that involves both sides of the brain at once. Partial seizures begin with an electrical discharge in one limited area of the brain. Many different things can cause partial seizures, for example head injury, brain infection, stroke, tumor, or changes in the way an area of the brain was formed before birth, called Cortical Dysplasia.

Symptoms vary from person to person. Some people may have simple staring spells. Others have violent shaking and loss of alertness. The type of seizure depends on the part of the brain affected and cause of epilepsy.

Most of the time, the seizure is similar to the one before it. Some people with epilepsy have a strange sensation before each seizure. Sensations may be tingling, smelling an odor that is not actually there, or emotional changes. This is called an aura.

  1. Simple Partial Seizures.
    • Motor Seizures. These cause a change in muscle activity on one side of the body. For example, a person may have abnormal movements such as jerking of a finger or stiffening of part of the body, not the face or head, and can result in Dropfoot.
    • Sensory Seizures. These cause changes in any one of the senses.
    • Autonomic Seizures. These cause changes in the part of the nervous system that automatically controls bodily functions.
    • Psychic Seizures. These seizures change how people think, feel, or experience things.

  2. Absence Seizure also known as Petit Mal.
    An absence seizure causes a short period of "blanking out" or staring into space.

  3. Atypical Absence Seizure.
    Eye blinking or slight jerking movements of the lips may occur.

  4. Atonic Seizure.
    Muscles suddenly lose strength - The eyelids may droop, the head may nod, and the person may drop things and often falls to the ground.

  5. Clonic Seizures.
    Rapidly alternating contraction and relaxation of a muscle - The movements cannot be stopped by restraining or repositioning the arms or legs.

  6. Myoclonic Seizures.
    Shock-like jerks of a muscle or a group of muscles - rapidly alternating contraction and relaxation.

  7. Tonic Seizures.
    Muscle "tone" is the muscle's normal tension at rest. In a "tonic" seizure, the tone is greatly increased and the body, arms, or legs make sudden stiffening movements.

  8. Tonic-clonic Seizures also known as Grand Mal.
    The tonic phase comes first, all the muscles stiffen. Air being forced past the vocal cords causes a cry or groan. The person loses consciousness and falls to the floor. The tongue or cheek may be bitten, so bloody saliva may come from the mouth. The person may turn a bit blue in the face.

    After the tonic phase comes the clonic phase: The arms and usually the legs begin to jerk rapidly and rhythmically, bending and relaxing at the elbows, hips, and knees. After a few minutes, the jerking slows and stops. Bladder or bowel control sometimes is lost as the body relaxes. Consciousness returns slowly, and the person may be drowsy, confused, agitated, or depressed.

    A seizure that lasts more than 10 minutes, or three seizures without a normal period in between, indicates a dangerous condition called Convulsive Status Epilepticus. This requires emergency treatment.

  9. Complex Partial Seizures.
    These seizures usually start in a small area of the temporal lobe or frontal lobe of the brain. They quickly involve other areas of the brain that affect alertness and awareness. So even though the person's eyes are open and they may make movements that seem to have a purpose, in reality "nobody's home." If the symptoms are subtle, other people may think the person is just daydreaming.

  10. Secondarily Generalized Seizures.
    These seizures are called "secondarily generalized" because they only become generalized (spread to both sides of the brain) after the initial event (a partial seizure) has already begun. They happen when a burst of electrical activity in a limited area (the partial seizure) spreads throughout the brain. Sometimes the person does not recall the first part of the seizure.

  11. Febrile Seizures.
    This is a form of Seizure that only occurs in children under the age of 1 as a result of high fever

  12. Non-Epilepsy Seizures also known as Psychogenic Seizures.
    The seizures most often act like complex partial or tonic-clonic (grand mal) seizures. - Psychogenic seizures are caused by subconscious thoughts, emotions or 'stress', not abnormal electrical activity in the brain.

7. Transportation

Different health issues make it unsafe to drive. In the United States anyone who has had a Seizure is not allowed to drive for a specific amount of time. The time until a person is legally allowed to drive again varies from state to state.

Anyone with the inability to drive because of Epilepsy, Blindness, Hearing Loss or physical mobility issues qualifies for Handicapped travel options in the United States. Information on how to get access to Handicapped Transportation can be easily done by finding an application online to apply for these services. The forms are often found at your local town offices, when not online at your local town's website.

8. Other Epilepsy Facts

Purple Day

Purple Day: March 26 is International Epilepsy Awareness Day.




9. Sources

  1. U.S. National Library of Medicine. PubMed Health. A.D.A.M. Medical Encyclopedia. Last reviewed: February 10, 2014. 'Epilepsy - Temporal lobe epilepsy; Seizure disorder'. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001714
  2. Schachter, Steven C. et al. Epilepsy Foundation. The Epilepsy Project. (2014) 'Epilepsy 101' http://www.epilepsy.com/learn/about-epilepsy-basics
  3. Schachter, Steven C. et al. Epilepsy Foundation. The Epilepsy Project. (2014) 'Type of Seizures' http://www.epilepsy.com/learn/types-seizures
  4. BC Epilepsy Society. (2008) 'Triggers for Epileptic Seizures' http://www.bcepilepsy.com/files/Information_Sheets/Triggers.pdf
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