Epilepsy: Causes, Symptoms, and Treatment Options

In epilepsy, seizures happen when the brain sends and receives abnormal electrical signals. There are different types of seizures:

• Focal seizures - they start in one area of the brain
• Generalised seizures - affect both sides of the brain

Focal seizures can be either

• simple - when a person remains aware of their surroundings

• complex - when they may lose consciousness and can have uncontrolled movements

There are different types of generalised seizures and each has its own unique symptoms. They are:

1. Tonic-clonic seizures: sudden onset of muscle spasms, loss of consciousness, and convulsions.
2. Absence seizures: short episodes of staring off into space, no facial expressions, and within this, a loss of awareness.
3. Myoclonic seizures: rapid and brief muscle jerks, usually affecting either the arms and legs, or both.
4. Atonic seizures: a sudden loss of muscle tone, becoming limp, causing the person to collapse or fall.
5. Tonic seizures: all of a sudden muscle contractions, causing the person to fall to the ground or lose balance.

Symptoms of epilepsy can vary, from changes in senses or perception before a seizure to a loss of consciousness, as well as muscle movements, altered sensations, cognitive changes, and autonomic symptoms. Some people may have epilepsy syndromes that cause “clusters” of seizures with specific symptoms, triggers, age of onset, and prognosis.

Genetic factors play a significant role in epilepsy, and having a family history of the condition increases the risk due to specific genetic mutations. Other things that increase risk are:

• Brain injuries
• Infections affecting the central nervous system
• Prenatal and perinatal factors
• Developmental disorders
• Triggers such as:
  • Sleep deprivation
  • Stress

How is Epilepsy Diagnosed?

When it comes to diagnosing epilepsy, an evaluation is necessary. This includes a detailed medical history, physical examination, and various tests like an electroencephalogram (EEG) to measure the electrical brain impulses, imaging studies of the brain and other areas, and blood tests to ensure there is no underlying cause. An EEG is helpful in detecting abnormal electrical activity in the brain, while imaging tests such as an MRI or CT scan help identify structural abnormalities.

In some cases, video EEG monitoring may be required to capture and characterise seizures when they occur. This complete approach helps understand the diagnosis, identify seizure types, determine potential causes, and guide treatments.

Anti-seizure medications are drugs that help control seizures and reduce their frequency and intensity. There are many different types of these medications available, each with their own set of benefits and potential side effects.

Here are some common examples of anti-seizure medications:

1. Carbamazepine (brand name Tegretol)
2. Valproic acid (brand name Depakote)
3. Lamotrigine (brand name Lamictal)
4. Phenytoin (brand name Epanutin)
5. Topiramate (brand name Topamax)
6. Gabapentin (brand name Neurontin)
7. Levetiracetam (brand name Keppra)
8. Oxcarbazepine (brand name Trileptal)

It's important to note that the specific medication or combination of medications recommended for an individual with epilepsy will depend on many factors, including the type of seizures they experience, their overall health, and any other medications they may be taking.

Other treatment options include:

• ketogenic diet

• vagus nerve stimulation (VNS)

• surgical interventions to remove or disconnect the epileptic focus

• lifestyle modifications such as adequate sleep and stress management

Living with epilepsy can present challenges, but with proper management and support, individuals can have fulfilling lives. Epilepsy can be managed through medication, safety precautions, response plans, diaries, and emotional support from healthcare professionals or support groups.

Remember, you're not alone, and there are resources available to help you navigate the challenges of living with epilepsy.

Alternative Therapies

In addition to traditional treatments, some people with epilepsy may consider alternative or complementary therapies such as acupuncture, herbal remedies, mindfulness and meditation, and dietary changes. Be wary that a large number of these therapies are not evidence-backed, but they may work for you. These approaches may not replace traditional treatments but can help support overall well-being and complement existing therapies.

Services for People with Epilepsy

These include the Epilepsy Action and other local UK support groups, seizure response dogs, educational and vocational services, and legal and advocacy resources. These resources can help people manage their condition effectively and improve their quality of life.

Researchers are working hard to find new and innovative ways to treat epilepsy. Some of the areas they are exploring include:

• precision medicine

• neurostimulation therapies

• gene therapy

• cannabinoids

• medical cannabis

• brain imaging

• biomarkers

By improving our understanding of epilepsy and developing new treatments, scientists hope to help people living with the condition better control seizures and improve their quality of life.

It is vital for individuals with epilepsy to feel empowered because this enables them to control their condition, speak for themselves, and live fulfilling lives. Advocacy for individuals with epilepsy aims at increasing awareness, decreasing stigma, improving access to resources and services, and establishing positive changes in legislation and policies. By educating themselves, speaking up for themselves, networking with peers and the community, and participating in research studies, people with epilepsy can take something tangible about improving their own health and others' within the epilepsy community.