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EpilepsyPublished by Bupa's health information team, healthinfo@bupa.com, November 2007. This factsheet is for people who have epilepsy, or who would like information about it. Epilepsy is a common condition which causes seizures, sometimes called fits, attacks or convulsions. These occur when some of the nerve cells in the brain become overactive and fire off uncontrolled random signals. About one to two in every 200 people have epilepsy.
About epilepsyEpilepsy is a neurological condition. This means it affects the brain and nervous system. Seizures can affect all or part of the brain. Areas of the brain called the temporal, occipital or frontal lobe are commonly affected. Each area of the brain performs different functions causing a different type of seizure - if the temporal lobe is affected, for example, this is called temporal lobe epilepsy. Symptoms of epilepsyThere are over 40 types of epilepsy and seizure. Some of the common epilepsy types are listed below. Partial seizuresSimple partial seizuresThis is when one small part of the brain is affected. If you have this type of seizure you may experience one or more symptoms including:
Complex partial seizuresThis type of seizure affects a larger part of the brain and often lasts longer than other types of epileptic seizure. If you have a complex partial seizure you may be only partly conscious, and you may not recall what happened. Symptoms may include:
Generalised seizuresThis is the type of seizure people most associate with epilepsy and is sometimes called grand mal epilepsy. This affects all or most of the brain at once. If you have this type of seizure you may lose consciousness and not recall what has happened. Tonic-clonic seizuresIf you have a tonic-clonic seizure, you may:
Clonic seizuresYou will twitch repeatedly but won't fall to the ground and won't go stiff in this type of seizure. Tonic seizuresIf you have a tonic seizure, you may go completely stiff and fall to the ground. Atonic seizuresDuring an atonic seizure, the muscles in your body go floppy. If you have this type of seizure, you may fall forwards to the ground. Myoclonic seizuresYour leg, arm, head or body will jerk in this type of seizure. This usually only happens in the morning. Absence seizuresYou may lose consciousness, or more often just awareness, but this kind of seizure doesn't involve falling down or experiencing involuntary jerking movements. In fact, you may just look as if you are daydreaming. This is also called petit mal epilepsy and isn't as obvious as a tonic-clonic seizure. This kind of seizure is most common in children and can continue into adulthood. Secondary generalised seizuresSecondary generalised seizures start as a partial seizure (either simple or complex) and develop into a generalised seizure such as a tonic-clonic seizure. Nocturnal seizuresThese seizures occur when you are asleep and can happen during the day or at night. Complications of epilepsyStatus epilepticusAny seizure or group of seizures that lasts longer than 30 minutes, without recovery in between is called status epilepticus. If this occurs during a tonic-clonic seizure, it's a medical emergency. SUDEPSudden unexpected death in epilepsy (SUDEP) is rare and can occur in a small number of individuals. Your doctor can explain this risk. Causes of epilepsyThe most common causes of epilepsy are:
Images of the nervous system, including the brain (see Diagnosis), can highlight the cause of epilepsy in two out of three people. Epilepsy with a known cause is called symptomatic epilepsy, if there is a likely cause it's called cryptogenic, and if there is no known cause it's called idiopathic. Diagnosis of epilepsyIf you experience repeated seizures - whether once a year, or several times a day - you may have epilepsy. To diagnose epilepsy, your GP will ask you about your seizures such as what happens before, during and after. Family members or friends can often help describe what happens to you during a seizure. Your GP may then refer you to a specialist for some tests. These can include an EEG (electroencephalogram), a brain scan which can be either a CT (computerised tomography) or an MRI (magnetic resonance imaging) scan and blood and urine tests. For information, please see Related topics. Some people have one seizure and then never have another again. This can occur in one in 20 people. Small children can have a febrile convulsion if there is a sudden rise in their body temperature at the same time as a fit - this is not usually epilepsy. For information, please see Related topics. Treatment of epilepsySelf-helpSome people can identify the triggers of their seizures. Triggers can include:
If you know what triggers a seizure, you may be able to find ways of avoiding the trigger to help to control your seizures. For example, if stress is a trigger you may benefit from relaxation and anti-stress exercises such as yoga. Keeping a diary to record your seizures can help to identify triggers. MedicinesThere is no cure for epilepsy, but epilepsy medicines can control seizures in around seven out of 10 people. These medicines may have side-effects such as drowsiness or a rash. Ask your doctor for more advice. If you haven't had a seizure for two years, your specialist may suggest you gradually reduce the dose and stop taking your epilepsy medicines. This depends on the type of epilepsy you have and this may not be suitable for some people. Complementary therapiesAromatherapy, acupuncture and reflexology may help to reduce stress and anxiety, which can trigger epilepsy in some people. Ask the therapist if the treatment you are considering is suitable for people with epilepsy. If you are taking any epilepsy medicines, check with your GP and pharmacist before taking or using any herbal remedy. Some herbal remedies such as St John's wort may be helpful for depression but can interfere with epilepsy medicines. Evening primrose oil and star oil can trigger epilepsy in some people. DietSome children with particular forms of epilepsy are recommended a ketogenic diet, which is high in fat and low in carbohydrates. This is individually calculated for each child by a dietician, so a certain amount of ketone bodies (produced when fat is burned) build up in the body. These appear to suppress seizures. Vagus nerve stimulationVagus nerve stimulation (VNS) can reduce seizures in some people. This is when an electrical device, implanted in the chest, regularly stimulates a nerve in your neck called the vagus nerve. The vagus nerve then sends signals to areas of the brain. This treatment is only available if other medicines haven't helped and neurosurgery (brain surgery) isn't possible. SurgeryYou may be offered neurosurgery if your epilepsy is severe and is not controlled after trying several different epilepsy medicines. This can only take place if the epilepsy is associated with a specific area of your brain. Your specialist will be able to explain your options to you. If someone has a seizureIt would be helpful for friends and family to know what to do if you have a seizure. If someone has a tonic-clonic seizure where they lose consciousness and have fits, remember to keep calm and check the time to monitor how long the seizure lasts. Protect them from injury by doing the following:
When the seizure stops, put the person on their side in the recovery position. After they re-gain consciousness, re-assure them and let them rest quietly in a safe place. Don't try to move or restrain the person and don't give them anything to drink until they are fully conscious again. You should call an ambulance only if:
If someone has a seizure that doesn't involve the loss of consciousness:
Living with epilepsyPeople with uncontrolled epilepsy may need to avoid certain activities or jobs where it could be dangerous to have a seizure - such as flying a plane, working at heights, riding a bicycle in busy traffic or swimming alone. Can I drive if I have epilepsy?Whether or not you have a confirmed diagnosis of epilepsy, if you have a seizure or suspected seizure at any time you must stop driving. Ask your doctor and the DVLA for further advice. If you stop taking epilepsy medicine, you can't drive while the medicine is being withdrawn or for six months afterwards. Identity card or jewelleryIt's a good idea for you to carry a card or wear a bracelet which says that you have epilepsy. If your epilepsy isn't controlled, you may decide to tell your family, friends, teachers and colleagues about the help you need if you have a seizure, or ask them to seek advice. Further information
Sources
Related topicsThis information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Dr Adrian Winbow MB, FRCPysch, DPM, Consultant Psychiatrist, Cygnet Hospital; and by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional. Date published: November 2007. Expected review date: November 2009.
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