Epilepsy is a lifelong condition that results in repeated seizures due to abnormal electrical discharges in damaged brain cells. A seizure occurs because of uncontrolled electrical activity among brain cells. This disruption can impact awareness, muscle control (causing muscles to twitch or jerk), sensations, emotions, and behavior.
Epilepsy can affect individuals of any age, race, or gender.
Nearly 3.4 million Americans are living with epilepsy, including 3 million adults and 470,000 children. Every year, the United States sees 150,000 new epilepsy diagnoses.
What Happens When You Have Epilepsy?
Your brain cells send and receive information through electrical impulses. These impulses are typically regular and consistent. With epilepsy, the usual electrical pattern gets interrupted by sudden spikes, leading to seizures. This disruption affects your awareness, sensations, emotions, and muscle control.
Types of Epilepsy
Epilepsy is classified based on where seizures originate in the brain, your level of awareness during a seizure, and whether muscle movements occur.
There are primarily two categories of seizures:
**Focal Onset Seizures** – These start in one specific area or network of cells in the brain. They are also known as partial-onset seizures and come in two types:
**Focal Onset Aware Seizure** – During these seizures, you remain awake and aware. Symptoms include:
- Altered senses (taste, smell, or sound)
- Emotional changes
- Uncontrolled muscle jerking, typically in the arms or legs
- Seeing flashing lights, feeling dizzy, or experiencing tingling sensations
**Focal Onset Impaired Awareness Seizure** – In these seizures, you may feel confused or lose awareness or consciousness. Symptoms include:
- Staring into space
- Repetitive movements like eye blinking, lip-smacking, chewing, hand rubbing, or finger motions
What Can Trigger Seizures or Epileptic Attacks?
Several factors may trigger seizures in those with epilepsy, including:
- Stress
- Alcohol use, alcohol withdrawal, or recreational drug use
- Hormonal changes or menstrual cycles
- Illness
- Flashing lights or patterns
- Poor diet, lack of fluids, vitamin, and mineral deficiencies
- Physical exhaustion
- Caffeine
- Dehydration
- Specific times of day or night
- Certain medications
- Missed doses of anti-seizure medications
- Sleep issues such as insufficient sleep, overtiredness, disrupted sleep, or sleep disorders like sleep apnea
Signs and Symptoms of an Epileptic Seizure
The primary symptom of epilepsy is recurrent seizures, though symptoms can differ based on seizure type:
Signs and symptoms can include:
- Temporary loss of consciousness or awareness
- Muscle jerking, loss of muscle tone, and uncontrolled muscle action
- Blank stares or “staring into space”
- Temporary disorientation, slow thinking, and communication or comprehension difficulties
- Changes in taste, smell, hearing, vision, or sensations of tingling or numbness
- Difficulty understanding or speaking
- Goosebumps, temperature changes like waves of heat or cold, and stomach upset
- Lip-smacking, chewing motions, and hand or finger rubbing
Note: Most individuals with epilepsy experience similar symptoms during each seizure because they usually have the same type of seizure each time.
How is Epilepsy Diagnosed?
Epilepsy is typically diagnosed if you have two or more seizures not caused by a known medical condition, such as alcohol withdrawal or low blood sugar.
Your healthcare provider (or an epilepsy specialist) will conduct a physical exam, gather your medical history, and perform blood tests. They will also request additional assessments and inquire about your symptoms before and after seizures.
Diagnostic tests include:
- Electroencephalography (EEG) – This test records electrical activity in the brain.
- Brain Scans – MRI scans to detect tumors, infections, or blood vessel abnormalities.
How to Treat Epilepsy
Epilepsy can be managed using anti-seizure medications, specific diets (sometimes combined with medications), and surgery.
- 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