What Are the Warning Signs of Epilepsy?

Epilepsy, also called seizure disorder, is a group of neurological conditions characterized by recurrent seizure episodes.

A seizure is a strong surge in the electrical activity of the brain. When a person suffers from two or more unprovoked seizures, they are diagnosed with epilepsy.

Epilepsy is the fourth most common neurological disorder and can affect people of all ages and ethnic backgrounds.

A seizure can last from a few seconds to a few minutes and could be triggered by certain factors, such as:

• Stress
• Not sleeping well
• Skipping meals
• Infections
• Missing prescribed medications
• Alcohol and drugs, such as caffeine and nicotine
• Flashing lights
• A sudden strong emotion, such as joy, sadness, fear, or anger
• Unpleasant smells

Seizures are classified into two main groups, including:

1. Generalized seizures: Affects widespread areas throughout the brain.
   • Tonic: Associated with muscle stiffness or rigidity.
   • Clonic: Associated with repeated, rhythmic, and jerky muscle movements.
   • Tonic-clonic: Also called grand mal seizures. The person loses consciousness and collapses. There are generalized tonic and clonic movements of the body.
   • Myoclonic: Sudden brief jerks or twitches.
   • Atonic: Also called drop seizures because the person falls due to loss of muscle tone.
   • Absence seizures: Typically occur in children, also called petit mal seizures.
2. Focal seizures: Also called partial seizures, they affect a localized area of the brain.
   • Simple: Person is aware and conscious.
   • Complex: Impaired consciousness.

Most seizure episodes stop on their own and cause minimal concerns.

If you experience warning signs, the following tips may help to get through the episode safely:

• Get to a safe place and alert someone about the condition.
• Do not put anything in the mouth.
• Do not drive, swim, or cook.
• Loosen tight clothing around the neck or head for comfortable breathing.
• Follow the seizure action plan (using a vagus nerve stimulator magnet, medicine, or other interventions when seizures occur).

Seizures are unpredictable, episodic, and stereotypic (similar symptoms in every episode) and can be caused by various conditions, including:

• Stroke
• Brain tumors
• Brain infections
• Traumatic brain or head injury
• Injury at the time of birth
• Genetic disorders, such as Down syndrome
• Other neurological disorders, such as Alzheimer’s disease
• Lack of oxygen to the brain
• Low blood sugar
• Idiopathic (unknown)

Epilepsy can be diagnosed based on physical symptoms, medical history, and certain diagnostic tests.

• A thorough neurological examination
• Electroencephalogram, a procedure to check the brain's electrical activity
• Blood test to check blood sugar, electrolytes, and other substances
• Imaging tests of the brain, such as magnetic resonance imaging or computed tomography scan
• Lumbar puncture to measure the pressure in the brain

Currently, there is no complete cure available for epilepsy. However, a neurologist (a doctor who specializes in treating diseases of the nervous system) will be able to diagnose and provide treatments and therapies, such as medications, antiseizure devices, dietary changes, and surgery, to help the patient live a seizure-free life.

The most common treatments for epilepsy include:

• Medications: Antiepileptic drugs are helpful to limit the spread and frequency of seizure episodes.
• Surgery: Surgical removal of the affected part of the brain may help stop further episodes.
• Other treatments: When medicines fail to improve the condition and surgery is not the option, the following are used
  • Vagus nerve stimulation (An electrical device is implanted under the skin on the upper chest to send signals to the vagus nerve in the neck.)
  • Low carbohydrate or ketogenic diet