In a healthy brain, nerve cells communicate with each other through electrical impulses that work together to control the body. But when those cells, called neurons, misfire or signal abnormally, a person can experience a number of sensations, emotions, behaviors, convulsions, muscle spasms and even loss of consciousness during what's called a seizure. If a person has more than one unprovoked seizure, she may be suffering from epilepsy. An individual is considered to have epilepsy when seizures recur over a period of time without an obvious provoking reason, such as alcohol withdrawal or electrolyte imbalances in the blood. Epilepsy cannot currently be cured, but it can be successfully treated and does spontaneously disappear in some patients.
The symptoms of epilepsy are complex. A seizure can be as subtle as staring off into space for a few moments, as if daydreaming. Other types of seizures cause more dramatic symptoms, including uncontrollable movements, loss of consciousness, stiffening, jerking, and loss of some bodily functions, among other symptoms. These symptoms can be as brief as a few seconds or as long as several minutes.
According to the Epilepsy Foundation and the U.S. Centers for Disease Control and Prevention, about 200,000 Americans will learn that they have epilepsy this year, and an estimated 2.7 million are currently living with the disorder. Men are at a slightly higher risk to develop epilepsy in childhood, but in adulthood the incidence of epilepsy is equal among men and women. The CDC estimates that this neurological disease costs approximately $15.5 billion annually in medical costs and lost or reduced earnings and production.
Epilepsy is not contagious and is not caused by mental illness or retardation. But for most people who suffer from this chronic condition, the stigma associated with it is enormous and affects just about every aspect of life. Family life, driving, employment, social interactions and self-image are just a few lifestyle considerations that confront people with epilepsy. Just the fear of having a seizure produces tremendous ongoing anxiety for some people—a burden for even those whose seizures are generally well controlled with medication.
There is no single cause of epilepsy, and in many cases, no known cause is ever found. Conditions that can lead to epilepsy include:
injury to the brain before, during or after birth
infections that damage the brain
toxic substances that affect the brain
injury and lack of oxygen to the brain
disturbance in blood circulation to the brain (stroke and other vascular problems)
metabolism or nutritional imbalance
tumors of the brain
genetic or hereditary abnormalities
high fever
other degenerative diseases
malformation of the brain
Seizures can be triggered by a variety of things, such as failure to take seizure-controlling medication as prescribed, lack of sleep, alcohol consumption or hormonal changes associated with the menstrual cycle. Failure to take medication is the most common trigger.
Epilepsy and Reproductive Health Issues
Epilepsy is associated with many reproductive health issues for women. Although it is not well understood, researchers know that the female hormones estrogen and progesterone act on certain brain cells, including those in a part of the brain called the temporal lobe, where partial seizures often begin. Therefore, estrogen and progesterone can affect the frequency and severity of seizures. Some women experience changes in their seizure patterns at times of hormonal fluctuations such as puberty, ovulation, the beginning of menstruation, pregnancy and even at menopause. This hormone-seizure interaction makes each life stage—and sometimes each menstrual period—a unique challenge. Because seizures disrupt regions of the brain that regulate reproductive hormones, women who have seizures also are more likely to have reproductive problems such as polycystic ovarian disease, early menopause and irregular ovulation leading to infertility.
Even birth control choices are affected by epilepsy. Certain antiepileptic medications (medications that control seizures) make hormonal birth control less effective in preventing pregnancy. Hormonal birth control includes oral contraceptives (birth control pills), long-acting progestin shots and implants and intrauterine devices that release hormones. While most women with epilepsy can have healthy babies, they are advised to work with health care professionals knowledgeable about seizure disorders to guard against increased risks for malformations to the baby or complications during pregnancy.
Why Epilepsy Happens
Epilepsy was one of the first brain disorders described, dating back to ancient Babylon more than 3,000 years ago. Over the years, many misconceptions have ensued. Epilepsy is a disorder in which the normal pattern of brain activity becomes disturbed. During a seizure, neurons fire as many as 500 times a second, far exceeding the normal rate of about 80 times a second. The resulting seizure can occur at any time of day or night with little or no warning. Attacks can occur frequently or rarely.
Genetic abnormalities may be the most significant factor contributing to epilepsy. The condition may run in some families, and some researchers say that more than 500 genes could be linked to the disorder.
For many people, epilepsy is the result of brain injury from other conditions or disorders. Heart attacks and strokes, for example, deprive the brain of oxygen and can cause damage that produces epilepsy. Conditions that affect the brain's normal workings, such as brain tumors, Alzheimer's disease and alcoholism, also may trigger it. Metabolic disorders such as pyruvate deficiency and other brain disorders such as cerebral palsy, neurofibromatosis and autism are all associated with an increased risk of epilepsy, as well.
Virtually any sort of injury to the brain, from head trauma to poisoning (such as from carbon monoxide or even illegal drug use) to infections can lead to seizures and epilepsy.
Cases that do not involve brain damage, injury, known genetic factors or any other known cause are known as idiopathic epilepsy. Research continues on the cause of epilepsy.
Types of Seizure and Epilepsy: Many and Varied
To date, researchers have identified more than 20 kinds of seizures and numerous syndromes and other conditions that include recurring seizures. People can have one or more than one type of seizure. In general, there are two kinds of seizures:
Partial seizures. Partial seizures are the most common type of seizure in people with epilepsy; about 60 percent of people with epilepsy have partial seizures, which occur in just one part of the brain and affect the physical and mental activity controlled by that area of the brain. Also called focal seizures, partial seizures may be simple or complex.
During a simple partial seizure, you may remain conscious and experience unexplained feelings or sensations, such as joy, sadness, anger or nausea. In a complex partial seizure (also called a psychomotor or temporal lobe seizure), you may experience an altered consciousness, display repetitious behavior or movements and not be able to interact with others until the seizure subsides. Emotional changes may also occur during the seizure. Complex partial seizures occur in adults, although the condition typically begins in childhood. Repeated seizures in the temporal lobe of the brain can, over a long period of time, affect memory and learning.
Generalized seizures. There are many types of generalized seizures, which result from abnormal neuronal activity on both sides of the brain. Generalized seizures involve bursts of electrical energy that sweep through the whole brain at once, causing loss of consciousness for seconds or minutes, falls, convulsions or muscle spasms.
Absence seizures (formerly called petit mal seizures) are a common type of generalized seizure that typically starts in childhood and typically stops when the child reaches puberty. During an absence seizure, a child may experience temporary lapses of consciousness that look like blank staring.
When seizures occur, a health care professional will determine if they are associated with epilepsy or another condition. Determining the underlying cause is critical to effective and appropriate treatment.
The many types of epilepsy are usually described by a specific group of symptoms. Some of the more common types include:
Frontal lobe epilepsy. Sudden onset and termination of a cluster of very short seizures are the hallmarks of this type of epilepsy.
Occipital lobe epilepsy. This type usually begins with visual hallucinations, rapid eye blinking or other eye-related symptoms. After that, it resembles temporal or frontal lobe epilepsy.
Temporal lobe epilepsy. This type typically has a "warning" or aura of altered perceptions (déjà vu, jamais vu, epigastric sensations, foul taste or odor) followed by altered awareness, confusion and responsiveness and other unusual behaviors and patterns of cognition.
The symptoms of epilepsy are complex. A seizure can be as subtle as staring off into space for a few moments, as if daydreaming. Other types of seizures cause more dramatic symptoms, including uncontrollable movements, loss of consciousness, stiffening, jerking, and loss of some bodily functions, among other symptoms. These symptoms can be as brief as a few seconds or as long as several minutes.
According to the Epilepsy Foundation and the U.S. Centers for Disease Control and Prevention, about 200,000 Americans will learn that they have epilepsy this year, and an estimated 2.7 million are currently living with the disorder. Men are at a slightly higher risk to develop epilepsy in childhood, but in adulthood the incidence of epilepsy is equal among men and women. The CDC estimates that this neurological disease costs approximately $15.5 billion annually in medical costs and lost or reduced earnings and production.
Epilepsy is not contagious and is not caused by mental illness or retardation. But for most people who suffer from this chronic condition, the stigma associated with it is enormous and affects just about every aspect of life. Family life, driving, employment, social interactions and self-image are just a few lifestyle considerations that confront people with epilepsy. Just the fear of having a seizure produces tremendous ongoing anxiety for some people—a burden for even those whose seizures are generally well controlled with medication.
There is no single cause of epilepsy, and in many cases, no known cause is ever found. Conditions that can lead to epilepsy include:
injury to the brain before, during or after birth
infections that damage the brain
toxic substances that affect the brain
injury and lack of oxygen to the brain
disturbance in blood circulation to the brain (stroke and other vascular problems)
metabolism or nutritional imbalance
tumors of the brain
genetic or hereditary abnormalities
high fever
other degenerative diseases
malformation of the brain
Seizures can be triggered by a variety of things, such as failure to take seizure-controlling medication as prescribed, lack of sleep, alcohol consumption or hormonal changes associated with the menstrual cycle. Failure to take medication is the most common trigger.
Epilepsy and Reproductive Health Issues
Epilepsy is associated with many reproductive health issues for women. Although it is not well understood, researchers know that the female hormones estrogen and progesterone act on certain brain cells, including those in a part of the brain called the temporal lobe, where partial seizures often begin. Therefore, estrogen and progesterone can affect the frequency and severity of seizures. Some women experience changes in their seizure patterns at times of hormonal fluctuations such as puberty, ovulation, the beginning of menstruation, pregnancy and even at menopause. This hormone-seizure interaction makes each life stage—and sometimes each menstrual period—a unique challenge. Because seizures disrupt regions of the brain that regulate reproductive hormones, women who have seizures also are more likely to have reproductive problems such as polycystic ovarian disease, early menopause and irregular ovulation leading to infertility.
Even birth control choices are affected by epilepsy. Certain antiepileptic medications (medications that control seizures) make hormonal birth control less effective in preventing pregnancy. Hormonal birth control includes oral contraceptives (birth control pills), long-acting progestin shots and implants and intrauterine devices that release hormones. While most women with epilepsy can have healthy babies, they are advised to work with health care professionals knowledgeable about seizure disorders to guard against increased risks for malformations to the baby or complications during pregnancy.
Why Epilepsy Happens
Epilepsy was one of the first brain disorders described, dating back to ancient Babylon more than 3,000 years ago. Over the years, many misconceptions have ensued. Epilepsy is a disorder in which the normal pattern of brain activity becomes disturbed. During a seizure, neurons fire as many as 500 times a second, far exceeding the normal rate of about 80 times a second. The resulting seizure can occur at any time of day or night with little or no warning. Attacks can occur frequently or rarely.
Genetic abnormalities may be the most significant factor contributing to epilepsy. The condition may run in some families, and some researchers say that more than 500 genes could be linked to the disorder.
For many people, epilepsy is the result of brain injury from other conditions or disorders. Heart attacks and strokes, for example, deprive the brain of oxygen and can cause damage that produces epilepsy. Conditions that affect the brain's normal workings, such as brain tumors, Alzheimer's disease and alcoholism, also may trigger it. Metabolic disorders such as pyruvate deficiency and other brain disorders such as cerebral palsy, neurofibromatosis and autism are all associated with an increased risk of epilepsy, as well.
Virtually any sort of injury to the brain, from head trauma to poisoning (such as from carbon monoxide or even illegal drug use) to infections can lead to seizures and epilepsy.
Cases that do not involve brain damage, injury, known genetic factors or any other known cause are known as idiopathic epilepsy. Research continues on the cause of epilepsy.
Types of Seizure and Epilepsy: Many and Varied
To date, researchers have identified more than 20 kinds of seizures and numerous syndromes and other conditions that include recurring seizures. People can have one or more than one type of seizure. In general, there are two kinds of seizures:
Partial seizures. Partial seizures are the most common type of seizure in people with epilepsy; about 60 percent of people with epilepsy have partial seizures, which occur in just one part of the brain and affect the physical and mental activity controlled by that area of the brain. Also called focal seizures, partial seizures may be simple or complex.
During a simple partial seizure, you may remain conscious and experience unexplained feelings or sensations, such as joy, sadness, anger or nausea. In a complex partial seizure (also called a psychomotor or temporal lobe seizure), you may experience an altered consciousness, display repetitious behavior or movements and not be able to interact with others until the seizure subsides. Emotional changes may also occur during the seizure. Complex partial seizures occur in adults, although the condition typically begins in childhood. Repeated seizures in the temporal lobe of the brain can, over a long period of time, affect memory and learning.
Generalized seizures. There are many types of generalized seizures, which result from abnormal neuronal activity on both sides of the brain. Generalized seizures involve bursts of electrical energy that sweep through the whole brain at once, causing loss of consciousness for seconds or minutes, falls, convulsions or muscle spasms.
Absence seizures (formerly called petit mal seizures) are a common type of generalized seizure that typically starts in childhood and typically stops when the child reaches puberty. During an absence seizure, a child may experience temporary lapses of consciousness that look like blank staring.
When seizures occur, a health care professional will determine if they are associated with epilepsy or another condition. Determining the underlying cause is critical to effective and appropriate treatment.
The many types of epilepsy are usually described by a specific group of symptoms. Some of the more common types include:
Frontal lobe epilepsy. Sudden onset and termination of a cluster of very short seizures are the hallmarks of this type of epilepsy.
Occipital lobe epilepsy. This type usually begins with visual hallucinations, rapid eye blinking or other eye-related symptoms. After that, it resembles temporal or frontal lobe epilepsy.
Temporal lobe epilepsy. This type typically has a "warning" or aura of altered perceptions (déjà vu, jamais vu, epigastric sensations, foul taste or odor) followed by altered awareness, confusion and responsiveness and other unusual behaviors and patterns of cognition.
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