Epilepsy
Labels Epilepsy
- Definition .
- What Is Epilepsy?
- What Causes Epilepsy?
- What Triggers a Seizure?
- How Do Seizures Differ?
- How Is Epilepsy Diagnosed?
- How Is Epilepsy Treated?
- Can Epilepsy Be Prevented?
- Living with Epilepsy
Showing posts with label Epilepsy. Show all posts
Showing posts with label Epilepsy. Show all posts
Labels Epilepsy
Definition
Epilepsy (EP-i-lep-see) is a condition of the nervous system characterized by
recurrent seizures that temporarily affect a person’s awareness, movements,
or sensations. Epileptic seizures occur when powerful, rapid bursts of
electrical energy interrupt the normal electrical patterns of the brain. Some
cases of epilepsy are hereditary, or run in families, but scientists do not
know the cause of epilepsy in most other cases. Epilepsy is not contagious.
Erin’s Story
It happened at her birthday party. Eleven-year-old Erin was ready to blow
out the candles on her cake when she suddenly released a loud cry and
dropped to the carpet and lost consciousness. Her entire body became
rigid, and her girlfriends got scared. They became even more alarmed when
Erin’s arms and legs began to twitch and then to violently thrash about.
Her friends called to her, but she did not respond. Her mother had seen
this before and rushed to Erin’s side, while telling the girls to move away
nearby chairs and the glasses and other items that were near the edge of the
table. She knelt beside her daughter and, to make sure her daughter could
breathe easier, turned Erin onto her side and loosened the top button on
her shirt. She also asked one of the girls to get Erin’s older brother and
another to bring over a pillow from a sofa. She put the pillow under her
daughter’s head to keep it from banging on the floor. The thrashing seemed
to go on for a long time, but it actually lasted less than two minutes. Once
it slowed down and finally stopped, her friends became concerned again
because Erin just laid there. Her mother continued to watch Erin, and
Erin’s brother explained to the girls that his sister had had an epileptic
seizure that caused her to lose consciousness and made her body jerk
around. He said Erin would come around in a minute or two and would
be fine as soon as she had time to rest, and then he asked the girls to follow
him out of the room. Erin regained consciousness just as her brother said
she would. She was exhausted and more than a little embarrassed that her
friends had seen what had happened. She was also frightened, because she
had had a seizure before and now she was concerned that she would have
more in the future. Erin was glad her mother was there to comfort her.
recurrent seizures that temporarily affect a person’s awareness, movements,
or sensations. Epileptic seizures occur when powerful, rapid bursts of
electrical energy interrupt the normal electrical patterns of the brain. Some
cases of epilepsy are hereditary, or run in families, but scientists do not
know the cause of epilepsy in most other cases. Epilepsy is not contagious.
Erin’s Story
It happened at her birthday party. Eleven-year-old Erin was ready to blow
out the candles on her cake when she suddenly released a loud cry and
dropped to the carpet and lost consciousness. Her entire body became
rigid, and her girlfriends got scared. They became even more alarmed when
Erin’s arms and legs began to twitch and then to violently thrash about.
Her friends called to her, but she did not respond. Her mother had seen
this before and rushed to Erin’s side, while telling the girls to move away
nearby chairs and the glasses and other items that were near the edge of the
table. She knelt beside her daughter and, to make sure her daughter could
breathe easier, turned Erin onto her side and loosened the top button on
her shirt. She also asked one of the girls to get Erin’s older brother and
another to bring over a pillow from a sofa. She put the pillow under her
daughter’s head to keep it from banging on the floor. The thrashing seemed
to go on for a long time, but it actually lasted less than two minutes. Once
it slowed down and finally stopped, her friends became concerned again
because Erin just laid there. Her mother continued to watch Erin, and
Erin’s brother explained to the girls that his sister had had an epileptic
seizure that caused her to lose consciousness and made her body jerk
around. He said Erin would come around in a minute or two and would
be fine as soon as she had time to rest, and then he asked the girls to follow
him out of the room. Erin regained consciousness just as her brother said
she would. She was exhausted and more than a little embarrassed that her
friends had seen what had happened. She was also frightened, because she
had had a seizure before and now she was concerned that she would have
more in the future. Erin was glad her mother was there to comfort her.
What Is Epilepsy?
In a normal brain, millions of tiny electrical charges pass between nerve
cells and to all parts of the body. Those cells “fire” in an orderly and
controlled manner. This is not the case with epilepsy. In the brain of
a person with epilepsy, nerve cells in parts of the brain fire simultaneously
and repeatedly, sending out powerful, rapid electrical charges that
disrupt the brain’s normal function. During a seizure such as the one
experienced by Erin, brain cells can fire at up to four times their normal
rate, temporarily affecting how a person behaves, moves, thinks,
or feels.
Many people with epilepsy can sense that they are about to have a
seizure by something called an aura. An aura is a strange feeling—often
of unease, anxiety, or discomfort—that may be accompanied by sensing
or seeing flickering lights. Despite these warning signals, people with epilepsy
still cannot stop the oncoming seizure.
cells and to all parts of the body. Those cells “fire” in an orderly and
controlled manner. This is not the case with epilepsy. In the brain of
a person with epilepsy, nerve cells in parts of the brain fire simultaneously
and repeatedly, sending out powerful, rapid electrical charges that
disrupt the brain’s normal function. During a seizure such as the one
experienced by Erin, brain cells can fire at up to four times their normal
rate, temporarily affecting how a person behaves, moves, thinks,
or feels.
Many people with epilepsy can sense that they are about to have a
seizure by something called an aura. An aura is a strange feeling—often
of unease, anxiety, or discomfort—that may be accompanied by sensing
or seeing flickering lights. Despite these warning signals, people with epilepsy
still cannot stop the oncoming seizure.
What Causes Epilepsy?
Because epilepsy is not contagious, one person cannot catch epilepsy
from another. In about 7 out of 10 cases, doctors describe the disease as
idiopathic (id-ee-o-PATH-ik), which means the cause is unknown. Most
people with idiopathic seizures are between 5 and 20 years of age and
have no brain injuries or abnormalities. Many do, however, have a family
history of epilepsy or seizure disorders.
Some cases of the disease have known causes, which include the
following:
from another. In about 7 out of 10 cases, doctors describe the disease as
idiopathic (id-ee-o-PATH-ik), which means the cause is unknown. Most
people with idiopathic seizures are between 5 and 20 years of age and
have no brain injuries or abnormalities. Many do, however, have a family
history of epilepsy or seizure disorders.
Some cases of the disease have known causes, which include the
following:
- Maternal injury, infection, or illness that affects a developing fetus
during pregnancy. - Brain injury. Although brain injuries can occur at any age, the
highest incidence is among young adults. These injuries often
result from car collisions, sports accidents, and falls. Blows to the
head and gunshot wounds, particularly those that injure brain
membranes and tissues, can lead to epilepsy. In general, the more
severe the injury, the greater the chance of developing the disease. - Brain tumor or stroke. Either of these problems can lead to injury
or irritation of brain tissue. Especially among people 65 years old
and older, stroke is a common cause of epilepsy. - Metabolic abnormalities that result from complications from
diabetes, kidney failure, lead poisoning, use of alcohol or drugs, or
withdrawal from alcohol or drugs. - Degenerative disorders, such as cardiovascular disease and
Alzheimer’s disease. Along with stroke, these are common causes of
epilepsy among people over 65. - Infections. Epilepsy may develop after a major brain illness such as
meningitis, encephalitis, brain abscess, or severe infections of any
part of the body. Less frequently, mumps, measles, and diphtheria
can lead to the disease. - Complications of AIDS or other immune disorders, including systemic
lupus erythematosus.
What Triggers a Seizure?
Anyone can have a seizure, but seizures are usually very few and far between.
A person with epilepsy, by contrast, has many more seizures and experiences
them over a longer period of time. For a person with epilepsy, many
conditions that affect the brain can trigger a seizure. These triggers include
hormonal changes, such as those that occur during the menstrual cycle
or pregnancy; hunger; exhaustion or sleep deprivation; and rhythmic patterns
of sound, touch, or light (particularly strobe lights). In many cases,
an epileptic seizure is not a medical emergency. However, if a person goes
into something called status epilepticus, in which a seizure lasts longer than
30 minutes or two seizures rapidly follow one another, his or her life may
be in danger, and onlookers should summon medical assistance at once.
A person with epilepsy, by contrast, has many more seizures and experiences
them over a longer period of time. For a person with epilepsy, many
conditions that affect the brain can trigger a seizure. These triggers include
hormonal changes, such as those that occur during the menstrual cycle
or pregnancy; hunger; exhaustion or sleep deprivation; and rhythmic patterns
of sound, touch, or light (particularly strobe lights). In many cases,
an epileptic seizure is not a medical emergency. However, if a person goes
into something called status epilepticus, in which a seizure lasts longer than
30 minutes or two seizures rapidly follow one another, his or her life may
be in danger, and onlookers should summon medical assistance at once.
How Do Seizures Differ?
Because of the way a person appears during or after an attack, others
sometimes mistakenly believe the person is drunk, drugged, or mentally
ill. Epileptic seizures have different symptoms or characteristics depending
on where the seizure begins in the brain and how the electrical discharge
spreads across the brain. Epileptic seizures fall in two categories:
generalized seizures and partial seizures.
Generalized seizures
Generalized seizures affect nerve cells throughout
the cerebral cortex (the cauliflower-like outer portion of the brain),
or across all of the brain. The most common generalized seizures are:
Partial seizures are contained within one region of
the cerebral cortex. Types of partial seizures include the following:
There are two other types of mild seizures:
sometimes mistakenly believe the person is drunk, drugged, or mentally
ill. Epileptic seizures have different symptoms or characteristics depending
on where the seizure begins in the brain and how the electrical discharge
spreads across the brain. Epileptic seizures fall in two categories:
generalized seizures and partial seizures.
Generalized seizures
Generalized seizures affect nerve cells throughout
the cerebral cortex (the cauliflower-like outer portion of the brain),
or across all of the brain. The most common generalized seizures are:
- Generalized tonic-clonic seizure (formerly called grand mal).
Erin had this kind of seizure at her party. During the tonic phase of
this seizure, people often lose consciousness, drop to the ground,
and emit a loud cry as air is forced through their vocal cords. In
the clonic phase, body muscles can contract at once or in a series of
shorter rhythmic contractions. Usually, this kind of seizure lasts for
about one or two minutes, and a period of exhaustion (called the
postictal state) follows before the individual regains consciousness.
Afterward, the individual may be sleepy and possibly have a headache.
Incontinence often occurs during this type of seizure. - Absence seizure (formerly called petit mal). Loss of consciousness
in this seizure is often so brief that a person does not even change
positions. The person may display a blank stare, rapid blinking, or
chewing movements. Facial or eyelid muscles may jerk rhythmically.
Absence seizures often are genetic and occur mostly in children.
Partial seizures are contained within one region of
the cerebral cortex. Types of partial seizures include the following:
- Simple partial. In this type of seizure, the strong and rapid bursts
of electrical energy are only located in one part of the brain. The
patient is awake and alert during the seizure. Symptoms, which vary
depending on what area of the brain is involved, may include jerking
movements in one part of the body, emotional symptoms such
as unexplained fear, or an experience of abnormal smells or nausea. - Complex partial. In this type of seizure, a person loses awareness of
surroundings and is unresponsive or only partially responsive, because
the seizures affect the part of the brain that controls awareness. An
individual with this type of seizure may experience a blank stare, chewing
movements, repeated swallowing, or other random activity. After
the seizure, the patient has no memory of it. In some cases, the person
who has had the seizure may suddenly become confused, begin to
fumble, to wander, or to repeat inappropriate words or phrases.
There are two other types of mild seizures:
- Febrile seizures. Two to five percent of children ages three months
to five years of age have convulsions caused by a sudden spike in
body temperature often from an infection. Simple febrile seizures—
the most common form—last from a few seconds to ten minutes
and stop on their own. Complex febrile seizures last more than fifteen
minutes. They may occur more than once in 24 hours and
may also be confined to one side of the child’s body. Children commonly
outgrow febrile seasures. - Jacksonian seizures. Named for British neurologist John
Hughlings Jackson (1835–1911), in Jacksonian seizures, abnormal
electrical activity in a localized area of the brain causes brief alterations
in movement, sensation or nerve function. Seizures of this
type typically cause no change in awareness or alertness and are
temporary and swift.
How Is Epilepsy Diagnosed?
Because not every person who has a seizure necessarily has epilepsy, the
doctor must determine the seizure’s cause by a physical exam and medical
history, including descriptions of the seizures that have already occurred.
The doctor must assess risk factors such as sleep deprivation and alcohol
use, as well as possible head injuries, childhood seizures, or family history
of seizures.
The physician also wants to know if the patient has experienced an
aura; having experienced an aura helps confirm that the seizure is a brain
disorder and establishes its location. The doctor also asks about the nature
of the movements the person made during a seizure.
If the patient has indeed experienced an epileptic seizure, the doctor
then tries to identify the type of seizure. The first tool doctors use is an
electroencephalograph (e-lek-tro-en-SEF-a-lo-graf). Commonly known
as an EEG, this machine records electric currents in the brain and can
track abnormal electrical activity. If the EEG does not show the seizure
activity, or if certain other features in the patient’s physical exam or
medical history are present, then the doctor may try other types of scans,
including CT (computerized tomography) scans or MRIs (magnetic
resonance imaging).
doctor must determine the seizure’s cause by a physical exam and medical
history, including descriptions of the seizures that have already occurred.
The doctor must assess risk factors such as sleep deprivation and alcohol
use, as well as possible head injuries, childhood seizures, or family history
of seizures.
The physician also wants to know if the patient has experienced an
aura; having experienced an aura helps confirm that the seizure is a brain
disorder and establishes its location. The doctor also asks about the nature
of the movements the person made during a seizure.
If the patient has indeed experienced an epileptic seizure, the doctor
then tries to identify the type of seizure. The first tool doctors use is an
electroencephalograph (e-lek-tro-en-SEF-a-lo-graf). Commonly known
as an EEG, this machine records electric currents in the brain and can
track abnormal electrical activity. If the EEG does not show the seizure
activity, or if certain other features in the patient’s physical exam or
medical history are present, then the doctor may try other types of scans,
including CT (computerized tomography) scans or MRIs (magnetic
resonance imaging).
How Is Epilepsy Treated?
Treating epilepsy has three goals: to eliminate seizures or at least reduce
their frequency, to avoid side effects of long-term medical treatments, and
to assist in maintaining or restoring normal activities of daily living.
Medication Anticonvulsant medications can fully or partially control
most cases of epilepsy. If a person is free of seizures for several years, doctors
may reduce or even eliminate medication. In many cases, however,
epilepsy remains a lifelong, chronic condition with no medical treatment
guaranteeing remission or a permanent cure.
Surgery If drug therapy does not work, a surgical procedure can
remove the damaged cells that cause partial seizures. Cases qualify for surgery
if the tissue resides in one small area of the brain and the surgeon can
remove this tissue without harming a person’s mental abilities or personality.
Surgery on adults is sometimes successful, but it usually has better
results when performed on children and infants.
Diet Although it was discontinued as a therapy when medicines became
available, a ketogenic diet (a doctor-monitored, high-fat, high-calorie
diet) was reinstated in the treatment arsenal for epilepsy, especially for
children who do not respond to medicines. It does not, however, work
for all patients. Some people believe the diet can stop seizures by creating
ketosis (ke-TO-sis), a condition in which the body burns fat for energy
instead of glucose. Researchers continued as of the early 2000s to wonder
why diet has an impact on seizures.
Biofeedback When combined with other therapies, biofeedback has
been beneficial to some patients. Biofeedback uses electronic instruments
to monitor a person’s brain waves, blood pressure, heart rate, and skin
temperature. The patient learns techniques to lower these bodily functions
to more relaxed levels.
Other treatments In the early 2000s epilepsy research was an active
field. One promising technique called vagus nerve stimulation uses an
implanted device to prevent or at least lessen seizures by sending small,
regular bursts of electricity through the vagus nerve in the neck to the
brain.
their frequency, to avoid side effects of long-term medical treatments, and
to assist in maintaining or restoring normal activities of daily living.
Medication Anticonvulsant medications can fully or partially control
most cases of epilepsy. If a person is free of seizures for several years, doctors
may reduce or even eliminate medication. In many cases, however,
epilepsy remains a lifelong, chronic condition with no medical treatment
guaranteeing remission or a permanent cure.
Surgery If drug therapy does not work, a surgical procedure can
remove the damaged cells that cause partial seizures. Cases qualify for surgery
if the tissue resides in one small area of the brain and the surgeon can
remove this tissue without harming a person’s mental abilities or personality.
Surgery on adults is sometimes successful, but it usually has better
results when performed on children and infants.
Diet Although it was discontinued as a therapy when medicines became
available, a ketogenic diet (a doctor-monitored, high-fat, high-calorie
diet) was reinstated in the treatment arsenal for epilepsy, especially for
children who do not respond to medicines. It does not, however, work
for all patients. Some people believe the diet can stop seizures by creating
ketosis (ke-TO-sis), a condition in which the body burns fat for energy
instead of glucose. Researchers continued as of the early 2000s to wonder
why diet has an impact on seizures.
Biofeedback When combined with other therapies, biofeedback has
been beneficial to some patients. Biofeedback uses electronic instruments
to monitor a person’s brain waves, blood pressure, heart rate, and skin
temperature. The patient learns techniques to lower these bodily functions
to more relaxed levels.
Other treatments In the early 2000s epilepsy research was an active
field. One promising technique called vagus nerve stimulation uses an
implanted device to prevent or at least lessen seizures by sending small,
regular bursts of electricity through the vagus nerve in the neck to the
brain.
Can Epilepsy Be Prevented?
Many cases of epilepsy have no known cause, which makes prevention
a challenge. Those cases of epilepsy that result from injuries to the brain
can, however, often be prevented through safety precautions and good
health practices. These strategies include:
a challenge. Those cases of epilepsy that result from injuries to the brain
can, however, often be prevented through safety precautions and good
health practices. These strategies include:
- Buckling seat belts and observing speed limits when in a car
- Wearing approved helmets and protective headgear while skating,
bicycling, playing sports, or riding motorcycles - Using drugs only as prescribed
- Immunizing children against infectious diseases
Living with Epilepsy
Most people with epilepsy can lead normal and active lives, although they
must follow a few safety restrictions. People with epilepsy must be free of
seizures for a period of time specified by their home state before they are
permitted to drive. Laws prohibit people with uncontrolled seizures from
driving a car.
A person with a seizure disorder should avoid working in jobs that
involve heights, dangerous machinery, or underwater environments. To
avoid the risk of drowning during a seizure, taking showers is safer than
taking baths, and swimming in a pool or lake with other people is safer
than swimming alone.
People with epilepsy also are at risk for depression. In part, the depression
may stem from loss of mobility or from the effects of prejudice at
school or at work. Prejudice results when people fear the condition and
do not understand it. Children with epilepsy may become depressed if
their parents become overly protective and prevent them from engaging
in normal childhood activities. Depression is a particular problem among
adolescents, who may refuse to take their medication on schedule and,
therefore, may run the risk of additional seizures.
In addition, alcohol consumption makes people who have epilepsy
more susceptible to seizures, and the combination of alcohol and anticonvulsant
medications can be deadly.
Understanding the facts about epilepsy and providing a positive environment
in which treatment becomes a part of everyday life can help
people with epilepsy and their families.
must follow a few safety restrictions. People with epilepsy must be free of
seizures for a period of time specified by their home state before they are
permitted to drive. Laws prohibit people with uncontrolled seizures from
driving a car.
A person with a seizure disorder should avoid working in jobs that
involve heights, dangerous machinery, or underwater environments. To
avoid the risk of drowning during a seizure, taking showers is safer than
taking baths, and swimming in a pool or lake with other people is safer
than swimming alone.
People with epilepsy also are at risk for depression. In part, the depression
may stem from loss of mobility or from the effects of prejudice at
school or at work. Prejudice results when people fear the condition and
do not understand it. Children with epilepsy may become depressed if
their parents become overly protective and prevent them from engaging
in normal childhood activities. Depression is a particular problem among
adolescents, who may refuse to take their medication on schedule and,
therefore, may run the risk of additional seizures.
In addition, alcohol consumption makes people who have epilepsy
more susceptible to seizures, and the combination of alcohol and anticonvulsant
medications can be deadly.
Understanding the facts about epilepsy and providing a positive environment
in which treatment becomes a part of everyday life can help
people with epilepsy and their families.
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