About Epilepsy

What is Epilepsy?

Epilepsy is a neurological disorder, not a disease; it is sometimes referred to as a seizure disorder. People can have seizures without necessarily having a seizure disorder – high fevers, serious illnesses, drug or alcohol withdrawals, accidents etc. can all provoke seizures; however those seizures cease when the physical cause is treated. People are diagnosed with Epilepsy when they experience recurrent unprovoked seizures.

• The word epilepsy is derived from the Greek epilepsia, which in turn can be broken into epi- (upon) and lepsis (to take hold of, or seizure)
• A seizure results when neurons in the brain misfire and cause a temporary electrical disturbance in the brain
• A seizure may appear as a brief stare, a change of awareness or a convulsion
• Epilepsy is a highly unusual disorder because each individual with epilepsy has a unique experience – there are over 40 different types of seizures; the characteristics and frequency of seizures vary within and across individuals
• This can make the disorder very difficult to understand, diagnose and treat
• There is no cure for epilepsy today

While there are many different types of seizures, they are generally divided into 2 main categories: Partial Seizures and Generalized Seizures; the following are the most common types of each:

• Partial seizures begin in one place in the brain, called the seizure focus, and affect only part of the brain, while generalized seizures, occur throughout the whole brain at once. Within these two categories, seizures can be further segregated into complex partial, simple partial, absence and tonic-clonic seizures
• Simple partial seizures do not cause loss of consciousness and are typically brief, sometimes this type of seizure acts as a warning or premonition to another seizure, an event often referred to as an “aura”
• Complex Partial seizures often interfere with a person’s awareness and even inhibitions. Basic motor functions and speech are often impaired leading members of the public to assume they are inebriated
• Tonic-clonic (previously referred to as grand mal) are generalized seizures that cause a loss of consciousness, the body’s muscles to stiffen and jerk (or convulse), sometimes excess saliva can be present or the individual may even bite their tongue. These seizures are typically 1-3 minutes in length
• Myoclonic seizures are brief shock-like jerks of a muscle or a group of muscles. Each seizure only lasts a few seconds but people usually experience several seizures in a row. Myoclonic seizures can be triggered by flashing lights (many people mistakenly believe that flashing lights will cause any type of seizure). Individuals with progressive myoclonic seizures also experience tonic clonic seizures
• Absence seizures are perhaps the most difficult to recognize.  Most common among children, an absence seizure can be compared to “staring off into space” for 10 seconds or less and typically the individual returns to normal with no memory of the seizure
• Partial seizures can very quickly (within seconds) travel throughout the brain to become “secondarily generalized seizures”
  

Who can get Epilepsy?

• Epilepsy can occur in anyone at any time even without a family history or head injury – anyone with a brain can have a seizure
  
• More than half of all newly diagnosed patients are under the age of 16
• Epilepsy affects 50 million people worldwide; with over 300,000 Canadians and 2.5 million Americans living with epilepsy

What causes epilepsy?

The reasons why epilepsy begins are different for people of different ages. But what’s true for every age is that the cause is unknown for over half of those diagnosed with epilepsy.

• The causes of epilepsy can be divided into two groups: brain injuries and chemical imbalances in the brain
• Children may be born with a defect in the structure of their brain, or they may suffer a head injury or infection that causes their epilepsy
• Severe head injury is the most common known cause in young adults
• In middle age, strokes, tumors, and injuries are more frequent
• In people over 65, stroke is the most common known cause, followed by degenerative conditions such as Alzheimer’s disease
• Epilepsy can also be passed on genetically; although as with all inherited traits, it is not a given that a child will inherit a parent’s epilepsy, but they do have a higher risk than the general population
• Defects in genes don’t directly lead to epilepsy, but they can alter the excitability of brain in a way to predispose to the seizures. Typically, epilepsy develops because of multiple gene abnormalities or because of a gene abnormality in concert with an environmental trigger
• Heredity is most relevant to generalized seizures (absence, generalized tonic clonic and myoclonic seizures) with an inheritance risk of up to 20%. But if a parent has epilepsy due to a brain injury, the child’s chance of having epilepsy is only about 5%
• Seizures can also be timed to the menstrual cycle (catamenial epilepsy) and affect some females from the onset of puberty to menopause

How is Epilepsy Treated?

• Epilepsy is most commonly treated with anti-consultant medication, which causes noticeable and unpleasant side effects – although approximately 40% of people are unable to become seizure-fee with medication
• Approximately 10-15% of people with epilepsy are candidates for surgery to eliminate seizures; there are also alternative treatments and diets, but as with medication, they do not effectively prevent seizures for everyone
• Approximately 20-30% of people with epilepsy are unable to control their seizures even with the best medications
• Individuals with uncontrolled seizures experience feelings of diminished freedom, independence and personal safety
• With the advent of anti-convulsant medication, epilepsy was widely considered to be a non-fatal illness – even among those in the medical community – and research for a cure decreased significantly
• However, the reality is that the mortality rate is 2 to 3 times higher among people with epilepsy and the risk of sudden death is greater than the general population
• There is no cure for epilepsy today

*These statistics are available from Epilepsy Canada, Epilepsy Ontario, NINDS , The Epilepsy Foundation of America, The Epilepsy Therapy Project, UNAID and WHO