Understanding
Epilepsy & Brain Waves
Overview
What is Epilepsy?
Epilepsy is a complex medical condition that produces seizures. A seizure is a disturbance of the electrical activity in the brain that affects the central nervous system, which may affect some body functions.
The foundation for the diagnosis of epilepsy is two or more unprovoked seizures at any time during a person’s life. The seizures in epilepsy are unprovoked, meaning they are not caused by any other condition or situation.
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Examples of conditions or situations that could cause seizures that are not considered epilepsy include: having a high fever, drug or alcohol abuse, serious infection.
Epilepsy vs Seizure
Epilepsy vs Seizure
A seizure is a single event.
A person is considered to have epilepsy if he or she has two or more unprovoked seizures.
Anatomy of the Brain
The cerebrum is divided into two hemispheres. The left hemisphere controls the right side of the body and the right hemisphere controls the left side of the body. Aside from the hemispheres, the cerebrum is also broken up into four lobes – Frontal, Temporal, Parietal, and Occipital (as shown below). Each of these lobes perform very distinct functions for the body.
Risk Factors
Risk Factors Include:
AGE
The fastest growing populations with epilepsy are people under the age of 2 and over the age of 65
FAMILY HISTORY
People with a family history of epilepsy are at a greater risk to develop the condition
FEBRILE SEIZURES
Very high fevers can put people at a greater risk of developing epilepsy
BRAIN CONDITIONS
Brain infections, tumors, traumatic brain injury and dementia increase the risk of developing epilepsy
Triggers
Common Seizure Triggers
These triggers generally do not cause seizures in the normal population. However, people affected by epileptic seizures may recognize certain situations that may bring about the onset of a seizure.
• Fevers or other illnesses
• Photosensitivity – flashing bright lights or patterns
• Heavy alcohol or drug use
• Missing medication doses
• Low blood sugar levels, high potassium levels, or excessive caffeine
• Allergic reaction to certain medication
• Lack of sleep
• Stress
• Hormonal changes (in women)
Possible Signs
Possible Signs of Seizures in Children
It is important to notice any abnormal behaviors in your child, record these disturbances, and discuss them with your doctor for a more accurate diagnosis.
• Child suddenly stops what he or she is doing
• Muscles stiffen or spasm
• Sudden loss of tone; child goes limp and falls to the ground
• One or more brief jerks, either one side of the body or both
• Child becomes rigid
• Teeth clenched
• Brief loss of consciousness
• Unresponsiveness for a few seconds
• Staring
Disease Information
Classifications of Seizures
Diagnosing & Testing
Diagnosis
Physicians will typically utilize these tests to effectively diagnose a patient who might have epilepsy.
• Clinical evaluation
• General lab testing
• Neurophysiologic studies (e.g., EEG)
• Neuroimaging (e.g., MRI, PET, SPECT)
• Other special tests
What is EEG testing?
Treatment
Treatment
Pharmacologic treatment The foundation to epilepsy treatment is finding the proper anti-epileptic drugs (AEDs). Once identified, daily adherence to the treatment plan is key. These medications work on different targets in the brain to prevent seizures. There are over 20 different types of medications physicians can use to treat epilepsy.
Non-pharmacologic treatment Some physicians might choose to utilize one of these common forms of treatment, depending on the type of seizures that a patient experiences:
• Vagus nerve stimulator (VNS)
• Ketogenic diet
• Surgery
If you miss a dose or take medicine irregularly, you are at higher risk for having a seizure.
Set a daily reminder on your cell phone or computer to take your medicine
Myths
EPILEPSY MYTHS
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MYTH You can swallow your tongue during a seizure.
REALITY It is physically impossible to swallow your tongue. Additionally, never place an object in a person’s mouth during a seizure. It may injure the teeth or gums or block the airway. -
MYTH You should restrain someone having a seizure.
REALITY NEVER restrain a person having a seizure. It will run its course. You may roll the person on his or her side and place something soft behind the head to prevent injury. -
MYTH People with epilepsy are disabled.
REALITY Most people with epilepsy can live normal lives. With the proper treatment, their seizures can be managed or reduced. Only certain cases need special care that limits work or driving. -
MYTH Only kids have epilepsy.
REALITY Epilepsy can occur at any age, and especially over the age of 60 if the person has other health problems like dementia or stroke. -
MYTH If you have had a seizure, then you have epilepsy.
REALITY One seizure does not mean you have epilepsy. You need two or more unprovoked seizures to be diagnosed with epilepsy.
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References
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Adamolekun, Bola. “Seizure Disorders.” Merck Manual Professional Version. May 1, 2013. Retrieved from
http://www.merckmanuals.com/professional/neurologic-disorders/seizure-disorders/seizure-disorders. -
“Diagnosis.” Mayo Clinic. Accessed September 16, 2015. http://www.mayoclinic.org/diseases-conditions/epilepsy/diagnosis-treatment/diagnosis/dxc-20117234.
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“Epilepsy – In-Depth Report.” NY Times Health. Accessed September 16, 2015. http://www.nytimes.com/health/guides/disease/epilepsy/print.html.
"Epilepsy Myths." Epilepsy Foundation of San Diego County. Accessed September 17, 2015. http://epilepsysandiego.org.s163008.gridserver.com/epilepsy-myths/. -
“The Epilepsies and Seizures: Hope through Research.” National Institute of Neurological Disorders and Stroke. Accessed on September 16, 2015. http://www.ninds.nih.gov/disorders/epilepsy/epilepsy.htm.
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Freeman JM, Vinning EPG, Pillas DJ. Seizures and Epilepsy in Childhood: A Guide 3rd ed. Baltimore: John Hopkins Universtiy Press; 1990.
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Häggström M. Computed tomography of human brain, from base of the skull to top. Taken with intravenous contrast medium. Wikipedia, The Free Encyclopedia. January 17, 2008. https://commons.wikimedia.org/wiki/File:Computed_tomography_of_human_brain_-_large.png. Accessed April 28, 2016.
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Kim YK, Lee DS, et al. 18F-FDG PET in Localization of Frontal Lobe Epilepsy: Comparison of Visual and SPM Analysis. J Nucl Med 2002; 43:1167–1174.
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Schachter, Steven C., and Shafer, Patricia O. “Facts about Seizures and Epilepsy.” Epilepsy Foundation. July 1, 2013. Retrieved from
http://www.epilepsy.com/learn/epilepsy-101/facts-about-seizures-and-epilepsy. -
Schachter, Steven C., Shafer, Patricia O., and Sirven, Joseph I. “Missed Medicines.” Epilepsy Foundation. July 1, 2013. Retrieved from http://www.epilepsy.com/learn/triggers-seizures/missed-medicines.
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Schachter, Steven C., Cramer, Joyce A., and Shafer, Patricia O. Medication Adherence. Epilepsy Foundation. August 2013. Retrieved from https://www.epilepsy.com/learn/managing-your-epilepsy/managing-triggers/medication-adherence.
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Schachter, Steven C., Shafer, Patricia O., and Sirven, Joseph I. “What is a Seizure?” Epilepsy Foundation. March 1, 2014. Retrieved from http://www.epilepsy.com/learn/epilepsy-101/what-seizure.
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“Seizures and Epilepsy in Children,” John Hopkins Medicine, accessed on Sep 16, 2015 from http://www.hopkinsmedicine.org/healthlibrary/printv.aspx?d=90,p02621.
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“Symptoms and causes.” Mayo Clinic. Accessed on Aug 14, 2015. http://www.mayoclinic.org/diseases-conditions/epilepsy/symptoms-causes/dxc-20117207.
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Warwick J. Brain imaging with SPECT and PET. Continuing Medical Education. 2013;31(8):307-309. Retrieved from http://www.cmej.org.za/index.php/cmej/article/view/2805/3140. Accessed April 13, 2016.