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What is Epilepsy?

Epilepsy is a chronic illness that results in recurrent seizures due to abnormal electrical impulses sent by damaged brain cells. An episode is brought on by uncontrolled electrical activity within your brain cells. Changes in awareness, muscle control (your muscles may twitch or jerk), sensations, emotions, and behavior can all occur during an epileptic seizure.

Anyone can be affected by epilepsy regardless of age, race, and gender.

Nearly 3.4 million Americans have epilepsy. Three million of those are adults, and 470,000 are kids. Each year, 150,000 new cases of epilepsy are reported in the United States.

What happens when you have epilepsy?

All parts of your body can communicate with and receive information from the cells in your brain. A constant electrical impulse that moves from cell to cell transmits these messages.

This periodic electrical impulse pattern in your brain is disturbed by epilepsy. Instead, there are electrical activity spikes between cells in one or more regions of your brain. This electrical disruption in the brain affects your awareness (including loss of consciousness), sensations, emotions, and muscle actions.

Types of epilepsy

Epilepsy is divided into different types according to where in the brain they begin, how aware you are while having one, and whether or not you move your muscles.

There are two main categories of seizure activity:

Focal onset seizures – begins in one area, or network of cells, on one region of your brain. This seizure is sometimes also referred called as a partial-onset seizure.

Focused seizures come in two varieties:

Focal onset aware seizure – you are awake and aware during an episode. Symptoms include:

  • Changes in your senses (taste, smell or sound)
  • Changes in your emotions
  • Uncontrolled muscle jerking, usually in arms or legs
  • Seeing flashing lights, feeling dizzy, having a tingling sensation

Focal onset impaired awareness seizure – you are confused or have lost awareness or consciousness during an attack. Symptoms include:

  • Staring into space
  • Repetitive movements (for example, eye blinking, lip-smacking or chewing motion, hand rubbing or finger motions)

What can trigger seizures or epileptic attacks?

Seizure triggers are events that happen before the start of a seizure. The most common seizure triggers among patients with epilepsy include the following:

  • Stress
  • Alcohol use, alcohol withdrawal, recreational drug use
  • Hormonal changes or menstrual hormonal changes
  • Illness
  • Flashing lights or patterns
  • Not eating healthy, balanced meals or drinking enough fluids; vitamin and mineral deficiencies
  • Physical overexertion
  • Caffeine
  • Dehydration
  • Specific times of the day or night
  • Certain medications
  • Missed anti-seizure medication doses
  • Sleep issues such as not sleeping well, not getting enough sleep, being overtired, disrupted sleep and sleep disorders like sleep apnea

Signs and symptoms of an epileptic seizure

Recurrent seizures are epilepsy’s primary symptom. However, your symptoms may vary depending on the kind of seizure you have.

Signs and symptoms of seizures include:

  • Temporary loss of consciousness or awareness
  • Muscle jerking, loss of tone, and uncontrolled muscle action.
  • “Staring into space” or a blank stare
  • Temporary disorientation, sluggish thinking, communication and comprehension issues
  • Changes in taste, smell, hearing, vision, or sensations of tingling or numbness
  • Difficulty understanding or speaking
  • Goosebumps, waves of heat or cold, and an upset stomach
  • Lip-smacking, chewing gestures, hand and finger rubbing

Note: With each seizure, most epileptics experience identical symptoms because they frequently have the same type of seizure.

How is epilepsy diagnosed?

Technically, you are said to have epilepsy if you have two or more seizures that weren’t brought on by a known medical disease, like alcohol withdrawal or low blood sugar.

Your doctor (or epilepsy specialist) will do a physical examination, record your medical history, and order blood tests before reaching a diagnosis (to rule out other causes). They might also perform additional tests and inquire about your symptoms before and after the seizure.

Other tests for diagnosis include:

  • Electroencephalography (EEG) – This test measures the electrical activity in your brain.
  • Brain scans -Magnetic resonance imaging (MRI) to scan for tumors, infections or blood vessel abnormalities.

How to treat epilepsy?

Anti-seizure drugs, specific diets (sometimes in combination with anti-seizure medications), and surgery can be used to control epilepsy.

  • Anti-seizure drugs:
  • Acetazolamide
  • Brivaracetam
  • Cannabidiol
  • Carbamazepine
  • Cenobamate
  • Clobazam
  • Clonazepam
  • Eslicarbazepine acetate
  • Ethosuximide
  • Everolimus
  • Fenfluramine
  • Gabapentin
  • Lacosamide
  • Lamotrigine
  • Levetiracetam
  • Oxcarbazepine
  • Perampanel
  • Phenobarbital
  • Phenytoin
  • Piracetam
  • Pregabalin
  • Primidone
  • Rufinamide
  • Sodium valproate
  • Tiagabine
  • Topiramate
  • Valproic acid
  • Vigabatrin
  • Zonisamide
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