SEIZURE DISORDER (Epilepsy)

General Information

DEFINITION--A disturbance in the normal electrical functions of the brain characterized by sudden seizures, brief attacks of inappropriate behavior, change in one's state of consciousness or unusual movements. There are several different categories: mild types that can go almost unnoticed and severe types that can cause serious harm if they are not treated. Not all seizures are convulsions. A convulsion involves the nerves that control movement. Convulsions cause jerking, spastic muscle movement, altered consciousness and sometimes, loss of consciousness.

BODY PARTS INVOLVED--Nervous system.

SEX OR AGE MOST AFFECTED--Both sexes; all ages. Seizures usually begin between ages 2 and 14.

SIGNS & SYMPTOMS

> Simple partial seizures:

Tingling sensation in arm, finger or foot. Perception of a bad odor. Sees flashing lights. Remains conscious.

> Complex partial seizures:

Remains conscious, but sits motionless. Strange, repetitive or inappropriate movements or behaviors.

> Generalized convulsive seizures:

Sense or aura preceding the seizure. May cry out and fall to the ground unconscious. Loss of urinary and bowel control. Muscle spasms; may bite tongue. Thrashing movements; jerking of limbs. Deep sleep after the convulsion; awakens with headache and lack of memory about the episode.

> Generalized nonconvulsive (absent) seizures; (most common in children):

Remains conscious. Stares into space; appearance of daydreaming. Rhythmic blinking. Unawareness of the seizure.

CAUSES--

More than 50 brain disorders, but the organic cause can be determined in only 25% of cases. Common causes include:

• Brain damage at or before birth; lack of oxygen during pregnancy, labor or delivery.
• Severe head injury; stroke; brain infection; brain tumor or an expanding lesion that compresses the brain (occasionally).
• Lead poisoning.
• Meningitis; encephalitis; measles.

RISK INCREASES WITH

• Family history of seizure disorders.
• Breech-birth (slightly).

HOW TO PREVENT--No specific preventive measures. Avoid head injuries.

What To Expect

DIAGNOSTIC MEASURES--

• Medical history and exam by a doctor.
• Laboratory blood studies, EEG (See Glossary), x-rays of the head, CT or MRI scan.

APPROPRIATE HEALTH CARE

• Doctor's treatment; counseling.
• Rarely, when all else fails, brain surgery.

POSSIBLE COMPLICATIONS

• Continuing seizures (despite treatment).
• Seizures can be life-threatening if they occur in hazardous situations (driving or swimming).

PROBABLE OUTCOME--Epilepsy is incurable, except in relatively rare cases where epilepsy is caused by treatable brain damage, tumors or infection. However, anticonvulsant drugs can prevent most seizures and allow a near-normal life. Newer drugs are helping many patients who have not responded to standard treatments.

How To Treat

GENERAL MEASURES--

• Wear a Medic-Alert (See Glossary) bracelet or pendant that shows you have epilepsy.
• Avoid any circumstance that has triggered a seizure previously.
• In event of seizure, loosen clothing, lay person flat and protect from injury. Although frightening, seizures are rarely harmful in themselves.

MEDICATION--Your doctor will prescribe anticonvulsant drugs. Your response to treatment will be monitored. Medication changes or adjustments are often necessary. Learn as much as you can about your medication. The drugs used cause significant side effects, in addition to suppressing seizures. Drugs may be withdrawn gradually after freedom from seizures for a period of time. Many people (especially children) can then stay free of seizures without medication.

ACTIVITY--No restrictions. Most states allow persons with epilepsy to drive a vehicle after being seizure-free for 1 year.

DIET--

• Usually no special diet. Don't drink alcohol.
• Some patients, mainly children, whose seizures aren't controlled by drugs, may be prescribed a ketogenic (very high-fat) diet. It is not always effective.

Call Your Doctor If

New, unexplained symptoms develop during treatment for epilepsy.