What is epilepsy

Many people who have seizures take tests such as brain scans for a closer look at what is going on. These tests do not hurt. Learn more about how epilepsy is diagnosed external icon from the Department of Veterans Affairs. There are many things a provider and person with epilepsy can do to stop or lessen seizures. Read more about the treatment options for epilepsy in the National Institute of Neurological Disorders and Stroke publication: Seizures and Epilepsy: Hope Through Research external icon.

Many kinds of health providers treat people with epilepsy. Primary care providers such as family physicians, pediatricians, and nurse practitioners are often the first people to see a person with epilepsy who has new seizures.

These providers may make the diagnosis of epilepsy or they may talk with a neurologist or epileptologist. A neurologist is a doctor who specializes in the brain and nervous system.

An epileptologist is a neurologist who specializes in epilepsy. When problems occur such as seizures or side effects of medicine, the primary health provider may send the patient to a neurologist or epileptologists for specialized care. People who have seizures that are difficult to control or who need advanced care for epilepsy may be referred to an epilepsy centers.

Epilepsy centers are staffed by providers who specialize in epilepsy care, such as. Many epilepsy centers work with university hospitals and researchers.

There are several ways you can find a neurologist or an epileptologist near you. Your primary care or family provider can tell you about types of specialists. The American Academy of Neurology external icon and the American Epilepsy Society external icon provide a listing of its member neurologists and epilepsy specialists, including epileptologists. The National Association of Epilepsy Centers external icon also provides a list of its member centers, organized by state.

Self-management is what you do to take care of yourself. You can learn how to manage seizures and keep an active and full life. Begin with these tips:. Learn more about managing epilepsy. Women who have epilepsy face special challenges. Hormonal changes can cause some women with epilepsy to have more seizures during their period.

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Epilepsy is a disorder of the brain characterized by repeated seizures. A seizure is usually defined as a sudden alteration of behavior due to a temporary change in the electrical functioning of the brain. Normally, the brain continuously generates tiny electrical impulses in an orderly pattern.

These impulses travel along neurons — the network of nerve cells in the brain — and throughout the whole body via chemical messengers called neurotransmitters. In epilepsy the brain's electrical rhythms have a tendency to become imbalanced, resulting in recurrent seizures.

In patients with seizures, the normal electrical pattern is disrupted by sudden and synchronized bursts of electrical energy that may briefly affect their consciousness, movements or sensations.

Epilepsy is usually diagnosed after a person has had at least two seizures that were not caused by some known medical condition, such as alcohol withdrawal or extremely low blood sugar. If seizures arise from a specific area of the brain, then the initial symptoms of the seizure often reflect the functions of that area. The right half of the brain controls the left side of the body, and the left half of the brain controls the right side of the body. For example, if a seizure starts from the right side of the brain in the area that controls movement in the thumb, then the seizure may begin with jerking of the left thumb or hand.

Seizures vary so much that epilepsy specialists frequently re-classify seizure types. Typically, seizures belong in one of two basic categories: primary generalized seizures and partial seizures. The difference between these types is in how they begin. 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. Epilepsy in which the seizures begin from both sides of the brain at the same time is called primary generalized epilepsy.

Hereditary factors are important in partial generalized epilepsy, which is more likely to involve genetic factors than partial epilepsy — a condition in which the seizures arise from a limited area of the brain. Some partial seizures are related to head injury, brain infection, stroke or tumor but, in most cases, the cause is unknown. One question that is used to further classify partial seizures is whether consciousness the ability to respond and remember is impaired or preserved.

The difference may seem obvious, but there are many degrees of consciousness impairment or preservation. The following factors may increase the risk of seizures in people predisposed to seizures:. About half of the people who have one seizure without a clear cause will have another one, usually within six months.

A person is twice as likely to have another seizure if there is a known brain injury or other type of brain abnormality. If the patients does have two seizures, there is about an 80 percent chance of having more. If the first seizure occurred at the time of an injury or infection in the brain, it is more likely the patient will develop epilepsy than if the seizure did not happen at the time of injury or infection.

According to the Epilepsy Foundation , epilepsy affects three million people in the U. Epileptic seizures may be tied to a brain injury or genetics, but for 70 percent of epilepsy patients, the cause is unknown.

The Epilepsy Therapy Project notes that 10 percent of people will have seizures in their lifetime. Epilepsy affects more than , children under the age of 15 — and more than 90, young people in this group have seizures that cannot be adequately treated. The onset rate starts to increase when individuals age, particularly as they develop strokes, brain tumors or Alzheimer's disease , all of which may cause epilepsy.

Reports indicate that more than , adults over the age of 65 suffer from the disorder. More men than women have epilepsy. Children and adolescents are more likely to have epilepsy of unknown or genetic origin. Brain injury or infection can cause epilepsy at any age. The Epilepsy Foundation also reports that 70 percent of children and adults with newly diagnosed epilepsy can be expected to enter remission after having gone five years or more without a seizure while on medication.

In addition, 75 percent of people who are seizure-free on medication can be weaned from medication eventually. According to the National Institute of Neurological Disorders and Stroke , 20 percent of epilepsy patients have intractable seizures — seizures that do not respond to treatment. The reasons why epilepsy begins are different for people of different ages. But what is known is that the cause is undetermined for about half of all individuals with epilepsy, regardless of age.

Children may be born with a defect in the structure of their brain or they may suffer a head injury or infection that causes their epilepsy.

Severe head injury is the most common known cause in young adults. For middle-age individuals, strokes, tumors and injuries are more frequent catalysts. In people age 65 and older, stroke is the most common known cause, followed by degenerative conditions such as Alzheimer's disease.

Often, seizures do not begin immediately after a person has an injury to the brain. Instead, a seizure may occur many months later. A doctor makes his or her epilepsy diagnosis based on symptoms, physical signs and the results of such tests as an electroencephalogram EEG , computed tomography CT or CAT scan or magnetic resonance imaging MRI. It is essential that the type of epilepsy and the type of seizures both are diagnosed properly.

There are several major classifications of seizures and most are associated with specific forms of the disorder. Epilepsy may be treated with antiepileptic medications AEDs , diet therapy and surgery. Medications are the initial treatment choice for almost all patients with multiple seizures.

Some patients who only have a single seizure and whose tests do not indicate a high likelihood of seizure recurrence may not need medications.

The medications treat the symptoms of epilepsy the seizures , rather than curing the underlying condition. The drugs prevent seizures from starting by reducing the tendency of brain cells to send excessive and confused electrical signals.

With many different antiepileptic drugs currently available, choosing the right medication for an individual patient has become complicated. Before any drug is prescribed, patients should discuss potential benefits, side effects and risks with their doctors. Diet therapy may be utilized in some patients with specific forms of epilepsy. The most common diets utilized are the ketogenic diet and the modified Atkins diet.

The ketogenic diet is a special high-fat, adequate protein and low carbohydrate diet that is initiated over three to four days in the hospital. The modified Atkins diet is similar to the ketogenic diet but is slightly less restrictive. It can be initiated as an outpatient. Both diets have been shown to reduce seizures in approximately half the patients that are identified to be appropriate candidates. These are mainly children with refractory epilepsy who are not surgical candidates.

While approximately 70 percent of patients have well-controlled seizures with these modalities, the remaining 30 percent do not and are considered medically-resistant.

Patients with medically-resistant epilepsy are often treated at specialized epilepsy centers in a multi-disciplinary fashion. The team of trained specialists that collaborate to provide these patients with comprehensive diagnosis and treatment of epilepsy may include:. In patients whose seizures are medically resistant, surgery provides the best chance of complete control of seizures.

However, not all patients with refractory epilepsy are suitable candidates for surgery. People with frequent tonic-clonic seizures or people whose seizures aren't controlled by medications may be at higher risk of SUDEP. It's most common in those with severe epilepsy that doesn't respond to treatment. Epilepsy care at Mayo Clinic. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission.

This content does not have an English version. This content does not have an Arabic version. Overview Epilepsy is a central nervous system neurological disorder in which brain activity becomes abnormal, causing seizures or periods of unusual behavior, sensations and sometimes loss of awareness.

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Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references The epilepsies and seizures: Hope through research.

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