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Epilepsy: Definition, Causes, Symptoms, Diagnosis

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Watching a loved one experience an epileptic fit can be scary. Some may appear catatonic, staring blankly ahead. Others are more extreme, shaking uncontrollably, with only the white of their eyes exposed. 

Knowing what to do isn’t instinctual. But you can help.

In this article, we explain what epilepsy is, what causes it, the signs and symptoms to watch for, diagnosing epilepsy, and how to control your condition.   If you still have questions, don’t hesitate to reach out. 

What is epilepsy?

Epilepsy is a neurological disorder characterised by recurrent seizures in the brain. A seizure is an episode of abnormal electrical activity in the brain and can cause convulsions, muscle spasms, loss of consciousness, and changes in behaviour. 

It affects children, women and men of all ages. 

What causes epilepsy in the brain?

Epilepsy can be caused by;

  1. Brain injury due to contact sports or a car accident.
  2. Infections such as HIV, meningitis, viral encephalitis and even certain parasitic infections.
  3. Developmental disorders like autism.
  4. Anomalies in the brain, for instance, brain tumours, cavernous malformations and vascular malformations. It’s also not uncommon for stroke patients to develop epilepsy. 
  5. Prenatal trauma, such as a baby starved of oxygen to the brain during birth, nutrition deficiencies, infection, or early birth. 
  6. Genetics. A history of epilepsy in the family can increase your chances of experiencing epileptic seizures. 

But for some people, there are no identifiable causes. If you suspect that you may have epilepsy, these are the symptoms to look out for.

What are the symptoms of epilepsy in adults, children, and newborns?

While the symptoms of epilepsy can vary depending on the type of seizure a person experiences, typically, that person will experience the same symptoms every episode.

Symptoms in adults

Some common symptoms of seizures in adults include:

  • Convulsions: This is the most well-known symptom of epilepsy, characterised by muscle contractions and spasms.
  • Loss of consciousness: Some seizures cause a person to lose consciousness or become unaware of their surroundings.
  • Confusion: After a seizure, a person may be confused or disoriented for a short period.
  • A staring spell: Some people with epilepsy will have a staring spell, during which they appear to be staring blankly into space.
  • Unusual sensations: Some people experience unusual feelings such as a “rising” in the stomach or a sense of fear or déjà vu before a seizure.
  • Uncontrollable movements: Some seizures cause a person to make sudden, uncontrolled movements, such as flailing arms and legs.
  • Change in behaviour: Some seizures can cause a change in behaviour, such as sudden crying or laughing.

Symptoms in children

Children experiencing an epileptic seizure may:

  • Blink their eyes rapidly or stare unblinking for a short while
  • Lose bladder control and wet themselves
  • Fall suddenly due to a loss of consciousness or nod their head repeatedly
  • Become unresponsive or stiffen
  • Turn blue around their lips
  • Breathe erratically

Symptoms in newborns

Newborns having an epileptic seizure may experience many of the same symptoms as a child. They may also:

  • Thrash or struggle for no apparent reason
  • Take long breaks between breaths
  • Suck, smack or protrude their tongue
  • Roll their eyes back so the whites show, stare unblinking, flutter their eyelids
  • Do bicycle peddling movements with their legs
  • Jerk their legs and arms quickly

Not all seizures cause all symptoms, and the symptoms can vary from person to person. Also, seizures can be classified into different types, such as generalised seizures and focal seizures.

Book an appointment with your doctor if you experience a seizure during pregnancy or you have diabetes. Seek medical attention if an attack lasts more than five minutes or the person experiencing the episode doesn’t regain consciousness.

6 ways of diagnosing epilepsy

Typically epilepsy is diagnosed by reviewing your medical history, conducting a physical examination, and various tests. 

The process of diagnosing epilepsy typically includes the following steps:

  1. Medical history: Your doctor will take a detailed look into medical history, including any previous seizures or symptoms of seizures. They may also ask about any other health conditions you have, medications you’re taking, and if you have a family history of epilepsy.
  2. Physical examination: Your doctor will then perform a physical exam to check for any signs of neurological problems. This may include checking reflexes, muscle strength, and coordination.
  3. Blood tests: Blood tests are a quick way to check for any underlying medical conditions that could be causing seizures, such as an infection or genetics.
  4. Neurological examination: Your doctor will also perform a neurological examination to assess your mental state, memory recall, speech, and ability to understand and follow instructions.
  5. Electroencephalogram (EEG): Your doctor may recommend an EEG. It’s one of the most commonly used tests for diagnosing epilepsy. It records the electrical activity of the brain and can detect abnormal patterns.
  6. Imaging tests: Imaging tests such as magnetic resonance imaging (MRI) or computed tomography CT Scans may be used to check for any structural problems in the brain that could be causing seizures. 

What is an MRI?

An MRI is a painless and non-invasive procedure that uses radio waves and strong magnetic fields to produce detailed images of the body’s internal structures. Book your MRI Scan at ERAD here.

What is a CT Scan?

A CT Scan uses a series of X-rays to get a detailed picture of the brain’s structure. It gives radiologists a 3-dimensional view of your body’s bones, internal organs and tissues. Book your CT Scan at ERAD here.

Please understand that the diagnostic process can take time. You may also need to visit your doctor or specialist several times before a definitive diagnosis of epilepsy can be made.

Do seizures always show up on an MRI?

While an MRI is a useful tool for evaluating the brain, it doesn’t always detect an epileptic fit or the underlying causes of seizures.

An MRI scan can detect structural abnormalities in the brain, such as tumours or scar tissue caused by seizures. But seizures caused by genetic or metabolic disorders may not be visible on an MRI.

Can an MRI trigger a seizure?

An MRI (magnetic resonance imaging) scan is not known to trigger seizures. However, in rare cases, people with certain medical conditions could have a seizure during or immediately after an MRI scan. 

If you have a history of seizures or other medical conditions, please inform the technologist and radiologist before the MRI scan is performed. Additionally, using a contrast agent during the scan may also be a concern.

Can epilepsy be cured?

Unfortunately, epilepsy can’t be cured. But it can be controlled with medication. The goal of treatment is to reduce the frequency and severity of epileptic seizures and to prevent seizures from occurring.

Treating epilepsy

There are three ways of treating epilepsy. 

  1. Anti-seizure medications
  2. Surgery
  3. Therapies

Anti-seizure medications

Medications called antiepileptic drugs (AEDs) are the most common treatment for epilepsy. They work by stabilising the electrical activity in the brain. AEDs can effectively control seizures in about 70% of people with epilepsy.

You can sometimes stop taking the medication without worrying that you’ll experience another epileptic seizure. But be aware that it can take time for your doctor to determine the correct dosage. Your age, the severity and the type of seizures you experience can impact your doctor’s recommendations.

These medications can cause unpleasant side effects like:

  • Skin rashes
  • Coordination problems
  • Unclear thoughts
  • Tiredness or dizziness
  • A decrease in bone density 
  • Weight gain 
  • Depression

Surgery

When medication doesn’t work, doctors may recommend surgically removing the part of the brain causing seizures or implanting a vagus nerve stimulation device in that area.

A doctor will only recommend surgery if they know exactly where the seizure originates. This needs to be an area of the brain which won’t affect speech, sight, hearing, motor control, or language.

Some doctors will recommend an MRI-guided stereotactic laser ablation. Your doctor will direct a thermal laser probe at the part of the brain where the seizure occurs to destroy the tissue.

Therapies

If you prefer to try alternative treatments for epilepsy, speak to your doctor about:

  1. Vagus nerve stimulation (VNS): VNS therapy involves the implantation of a small device under the skin of the chest that sends electrical impulses to the brain via the vagus nerve. This can help to reduce the frequency and severity of seizures.
  2. Ketogenic diet: Adding a high-fat, low-carbohydrate diet can be effective in reducing seizures in some people with epilepsy, particularly children.
  3. Cognitive-behavioural therapy (CBT): CBT is a form of talk therapy that can help you (as someone who suffers from epilepsy) manage the emotional and psychological effects of the condition.

If you want to find the most effective treatment plan, it’s vital that you work with a neurologist who specialises in treating epilepsy.

Preventing an epileptic seizure

Knowing what causes your seizures is the first step to controlling their frequency. While medication, surgery, and therapies have the greatest impact on your condition, implementing vital lifestyle changes can also reduce their occurrence. 

These include but aren’t limited to:

  • avoiding triggers (document these in a diary)
  • getting enough sleep (aim for at least 8 hours a night)
  • regular exercise (it could be as little as 30 minutes a day)

When to see a doctor?

Are you concerned that your loved one may have epilepsy? Have you experienced more than one epileptic seizure? Reach out to your doctor and discuss your concerns. Speak to them about booking an MRI or CT Scan at ERAD. Let’s help you get a definitive diagnosis so you can live a happy life.

If you’d like to book an appointment, contact us here.

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