The name epilepsy comes from the Greek for "to be seized." Sudden, spontaneous seizure is the hallmark of this illness. It may involve falling to the ground and twitching spasmodically, but not always.
As the brain goes about its daily functions, millions of electrical and chemical signals pass from its nerve cells out to the body. These electrochemical messages are necessary for almost everything we do and feel.
Seizures are a sudden and abnormally high discharge of electrical activity among large numbers of nerve cells in the brain. This can result in involuntary and unusually large signals being sent to the muscles.
Epilepsy is one of the most common disorders of the central nervous system, affecting approximately 300,000 people in Canada. About a quarter of people with epilepsy in Canada will be diagnosed before the age of 10, and another third by the age of 19. The diagnosis of epilepsy is only made if there have been at least 2 episodes of unprovoked seizures on different days, or 1 episode of unprovoked seizure with a high chance of having another in the next 10 years. Having an "unprovoked" seizure means that there is no apparent trigger.
Epilepsy that first appears in adulthood is often due to some localized damage such as poor blood flow to the brain (including from a stroke), a brain tumour, or a previous head injury. Epilepsy in children can sometimes be brought on by meningitis during infancy or by abnormalities of brain development, but it is often inherited.
We know epilepsy can be passed on genetically, but we don’t really understand what’s different in the brain of a person with an inherited form of epilepsy. We also don’t fully understand what happens to the brain during a seizure. Many people find that particular events tend to trigger seizures. These include:
Catamenial epilepsy refers to seizures that are timed to the menstrual cycle. These seizures occur most during ovulation or just before menstruation. Seizures are apparently provoked by estrogen and prevented by progesterone. This explains why seizures begin around puberty for some people who menstruate, when estrogen dominates, and may improve after menopause.
Anticonvulsant medications will eliminate or reduce seizures in most people. These medications will likely only be started after a second seizure occurs. There are several types, and not all of them work in every case. Examples of anticonvulsants include carbamazepine, lamotrigine, phenytoin, topiramate, and valproic acid. A doctor may need to try a few before finding the right one for a given person.
Unfortunately, many anticonvulsants can have side effects. Some can make a person mentally sluggish. Some can provoke facial hair growth and even blunt facial features. In children, they may cause learning or behaviour issues. They can also reduce the effectiveness of the oral contraceptive pill and cause birth defects.
If a person hasn’t had a seizure while on medication for a long time (e.g. years), their doctor may discuss the possibility of slowly stopping the medication. Epilepsy is considered resolved if a person hasn’t had a seizure in at least 10 years and has not used antiseizure medication for at least 5 of those years.
Epilepsy originating from a damaged part of the brain may require surgery when medications are not enough. This can sometimes cure the problem.
An implanted pacemaker-type device that stimulates the vagus nerve in the neck at regular intervals can sometimes improve seizures. A person wearing this device who feels a seizure coming can sometimes stop it by waving a small magnet over the implant to turn the stimulator on.
Anyone who is sexually active and could become pregnant, including those who have epilepsy, should talk to their doctor about folic acid supplements that reduce the risk of birth defects. There are also treatments for the various sexual problems that may accompany epilepsy.
Exercise is generally beneficial to those with epilepsy, and people rarely have seizures during exercise. People with epilepsy should take some common-sense precautions to avoid injury, such as avoiding swimming or bathing unsupervised, operating heavy machinery, or climbing ladders. Although some precautions are necessary, parents should try not to be overprotective. People with epilepsy can lead full, happy, and productive lives.
All material copyright MediResource Inc. 1996 – 2026. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/Epilepsy
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