About one in 100 people in the United States will experience an unprovoked seizure in their lifetime
Epilepsy
Epilepsy is a disorder that results from the generation of electrical signals inside the brain, causing recurring seizures. Seizure symptoms vary. Some people with epilepsy simply stare blankly for a few seconds during a seizure, while others have full-fledged convulsions.
A solitary seizure doesn't mean you have epilepsy. At least two unprovoked seizures are required for an epilepsy diagnosis.
Even mild seizures may require treatment, because they can be dangerous during activities like driving or swimming. Treatment — which generally includes medications and sometimes, surgery — usually eliminates or reduces the frequency and intensity of seizures. Many epilepsy patients outgrow the condition with age.
Risk Factors For Epilepsy
Certain factors may increase your risk of epilepsy.
Your age. The onset of epilepsy is most common during early childhood and after age 65, but the condition can occur at any age.
Your sex. Men are slightly more at risk of developing epilepsy than are women.
A family history. If you have a family history of epilepsy, you may be at an increased risk of developing a seizure disorder.
Head injuries. These injuries are responsible for many cases of epilepsy. You can reduce your risk by always wearing a seat belt while riding in a car and by wearing a helmet while bicycling, skiing, riding a motorcycle or engaging in other activities with a high risk of head injury.
Stroke and other vascular diseases. These can lead to brain damage that may trigger epilepsy. You can take a number of steps to reduce your risk of such diseases, including limiting your intake of alcohol and avoiding cigarettes, eating a healthy diet and exercising regularly.
Brain infections. Infections like meningitis, which causes an inflammation in the brain or spinal cord, can increase your risk of epilepsy.
Prolonged seizures in childhood. High fevers in childhood can sometimes be associated with prolonged seizures and subsequent epilepsy later in life, particularly for those with a family history of epilepsy.
Preparing for Your Appointment
You're likely to start by first seeing your family doctor. However, in some cases when you call to set up an appointment, you may be referred immediately to neurologist, Dr. Rosenkilde: a physician with special experience in managing diseases and injuries of the brain.
Because there's often a lot of ground to cover, it's a good idea to be prepared for your appointment.
Here's some information to help you get ready for your appointment, and what to expect.
What you can do
- Keep a detailed seizure calendar. Each time a seizure occurs, write down the time, the type of seizure it was and how long it lasted. Also make note of any unusual circumstances, such as increased stress, menstruation or other events that might trigger seizure activity. Seek input from people who may observe your seizures — including family, friends and co-workers — so that you can record information you may not know.
- Write down key personal information, including any major stresses or recent life changes.
- Make a list of all medications, as well as any vitamins or supplements that you're taking.
- Take a family member or friend along. Sometimes it can be difficult to absorb all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot. Also, because you may not be aware of everything that happens when you are having a seizure, your doctor may want to ask questions of someone who has witnessed them.
- Write down questions for Dr. Rosenkilde.
Tests and Results
Dr. Rosenkilde may use a number of tests to diagnose epilepsy, from neurological exams to imaging techniques like MRI scans.
- Neurological and behavioral exam. Your doctor may want to test your motor abilities, behavior and intellectual capacity to see how the seizures are affecting you.
- Blood tests. Your doctor may take a blood sample to check for signs of infections, anemia or diabetes, which can cause seizures.
He may also suggest tests to detect abnormalities within the brain. These include:
- Neuropsychological tests. This group of tests includes IQ, memory and speech assessments, which help doctors pinpoint where the seizures are originating. This type of testing is routinely done before epilepsy surgery.
- Electroencephalogram (EEG). This is the most common test to diagnose epilepsy. An EEG records the electrical activity of your brain via electrodes affixed to your scalp. If you have epilepsy, it's common to have changes in the normal pattern of brain waves, even when you're not having a seizure.
- Sleep testing: Dr. Rosenkilde may want to monitor you on video while conducting an EEG of you awake or asleep in hopes of recording the seizure to see what kind of seizures you're having. Sometimes your doctor will have to do something to provoke a seizure while you're being tested, such as asking you to sleep very little the night before.
- Computerized tomography (CT). You might be given a CT scan if you go to an emergency room for an initial seizure, because it's generally a readily available test. CT machines use a type of X-ray equipment to obtain cross-sectional images of your brain and skull. CT scans can reveal abnormalities in the brain that might be causing your seizures, including tumors, bleeding and cysts.
- Magnetic resonance imaging (MRI). An MRI provides much the same type of information as a CT scan, but in far greater detail. MRIs use radio waves and a strong magnetic field to produce detailed images of your brain. MRIs can reveal brain abnormalities that could be causing your seizures.
- Functional MRI (fMRI). A functional MRI measures the changes in blood flow that occur when specific parts of your brain are working. Doctors generally use an fMRI before surgery to identify the exact locations of critical functions, like speech, so that surgeons don't injure those places while operating.
- Positron emission tomography (PET). PET scans use a small amount of low-dose radioactive material that's injected into a vein to help visualize active areas of the brain and detect abnormalities.
Lifestyle and Home Remedies
Understanding your condition can help you control it.
- Take your medication correctly. Don't take it upon yourself to adjust your dosage levels. Instead, talk to your doctor if you feel something should be changed.
- Get enough sleep. Sleep deprivation is a powerful trigger of seizures. Be sure to get adequate rest every night.
- Wear a medical alert bracelet. This will help emergency personnel know how to treat you correctly.
- Healthy life choices: managing stress, limiting alcoholic beverages and avoiding cigarettes.
[edited from mayoclinic.com/epilepsy]
