Epilepsy is a chronic noncommunicable brain disease that can affect people of all ages.
Neuraxpharm provides medication alternatives for epilepsy treatment as well as rescue medication for seizures. Once your doctor has determined your specific needs, they can prescribe the product that best adapts to your needs and condition.
Read on to learn about the main types of epileptic seizures, how they affect people and how epilepsy is diagnosed and treated.
Epilepsy is a neurological condition that affects the brain and nervous system. Epilepsy is considered a ‘spectrum disorder’ because it has numerous causes and several different seizure types and its severity and impact can vary from person to person, with a range of co-existing conditions.
People with epilepsy have a tendency to experience frequent seizures, which cause a huge range of symptoms, from becoming stiff or staring blankly into space to uncontrollable shaking or jerking.
Epileptic seizures start in the brain and are caused by a disturbance in the brain’s electrical activity. Other types of seizures, such as those caused by low blood sugar or heart problems, are not epileptic seizures. Learn more about the basic facts concerning epilepsy.
There are many types of epilepsy, including focal epilepsy, generalised epilepsy and combined generalised and focal epilepsies. Doctors will investigate the types of seizures that are experienced and what has caused them to help them to classify the type of epilepsy1.
There are over 40 different types of epileptic seizures. In some seizures people remain alert, while others can cause loss of awareness. They may cause shaking and jerking or give people unusual sensations. The main seizure types and their symptoms are covered in detail in the symptoms section below.
Epilepsy is one of the most common neurological (meaning it affects the nervous system) conditions in the world2. It affects people of any age, race and social class. Around 50 million people worldwide have the condition3, however it is estimated that up to 70% of people with epilepsy could live seizure-free with the correct diagnosis and treatment.
The main symptom of epilepsy is epileptic seizures. These are caused by sudden bursts of electrical activity in the brain which disrupt the function of the brain and mix up its usual messaging. Depending on which part of the brain is involved, seizures can affect people in different ways1.
The main symptom of epilepsy is recurrent seizures – these are often unpredictable and episodic, which means that they come and go. However, many people find it helpful to keep track of what happens before each seizure to help them build up a better understanding of any warning signs that are typical for them.
Most people with epilepsy have seizures that last for a short time (less than five minutes) and stop by themselves. But sometimes, a seizure can last longer than five minutes, or multiple seizures can happen with no recovery time in between. This is known as ‘status epilepticus’ and emergency assistance and/or medication may be required to end the seizure as quickly as possible.
Seizures are categorised into focal, which start in one part of the brain, and generalised, which involve all parts of the brain.
Focal seizures are generally brief, lasting less than two minutes.
Epilepsy does not have defined stages; it can come on quite suddenly and can start at any age. Anyone can have a single epileptic seizure, and this does not necessarily mean you have epilepsy.
Often, epilepsy is a life-long condition, although some types of epilepsy last for a limited time and the seizures will eventually stop.
Usually, seizures are unpredictable, brief and episodic, which means that they come and go, so it can be difficult to know when to expect them.
The signs can also vary for different people, so it’s a good idea to build up a picture of any warning signs that you get with each seizure to help you anticipate and prepare for a seizure. Warning signs may include:
Focal aware seizures are sometimes called ‘auras’ and are often seen as a warning that a tonic-clonic seizure is going to happen. These can involve a feeling of déjà vu (feeling like you’ve been here before), suddenly feeling intense fear or joy, tingling in the arms and legs, stiffness or twitching in the body, unusual tastes or smells and a ‘rising’ sensation in the tummy.
The causes of epilepsy are complex and not always easy to identify and often, epilepsy has no identifiable causes. It could be a result of a person’s genetics, a structural change in the brain or other underlying conditions such as brain tumours and infectious diseases, such as meningitis and viral encephalitis. Certain events can also make epileptic seizures more likely, such as lack of oxygen to a baby’s brain during childbirth or brain injury from an accident or a stroke. In adults with epilepsy, the risk of dying is up to three times higher4 than in the general population. Studies suggest that life expectancy can be reduced by up to 10 years when there is a known cause of epilepsy5.
Epilepsy can be linked to a genetic tendency or be caused by a change in the brain. This can include brain damage caused by:
Seizures can come on randomly, but many people find that certain factors can trigger them, including lack of sleep, stress, medication, drugs or alcohol, missing meals, waking up, menstruation and flashing or flickering lights. These factors do not cause epilepsy in themselves, but they are common triggers of epileptic seizures.
Around one in three people with epilepsy also has a family member with the condition, which suggests the cause is often hereditary. However, many people who have parents with epilepsy do not experience seizures or develop epilepsy themselves. It is also sometimes a result of a non-inherited genetic tendency, caused by a change in a person’s genes, which can happen as we get older.
Epilepsy can develop in anyone at any time in their life, but it’s most commonly diagnosed in children and in people over 65. This is because there are more likely causes during these stages of life, such as difficulties at birth and childhood infection or strokes in older people.
Once you have developed epilepsy it is often a lifelong condition, although there are many treatment options to help reduce seizures or even stop them altogether.
Sometimes, medication helps people to stay seizure-free for a year or more before experiencing another seizure apparently quite randomly. This is known as a ‘breakthrough seizure’ and can happen for different reasons. If you experience a breakthrough seizure it’s advisable to seek medical advice in case your treatment needs to be adjusted.
Many people remain on treatment for their whole life, but some people’s seizures disappear over time, which means they can stop taking medication. When epilepsy goes away like this it is called spontaneous remission.
People who are diagnosed with epilepsy have a tendency to experience repeated seizures that start in the brain, so doctors are only likely to investigate when you have experienced more than one seizure.
Having a single seizure doesn’t mean you have epilepsy, however, if you have experienced a seizure ensure that you talk to your GP or primary care giver straight away so that they can begin exploring the cause.
First, doctors will look to determine whether the seizures you are experiencing are starting in the brain or not. Other types of seizures, such as those caused by low blood sugar or heart problems, are not associated with epilepsy.
If they believe it may be epilepsy, you will usually be referred to a neurologist, which is a doctor who specialises in conditions affecting the brain and nerves.
There is no single test to diagnose epilepsy, so it can be a lengthy process while doctors look at a range of information to find out what’s causing the seizures. Often, the symptoms can appear similar to other conditions like panic attacks, migraines or fainting, so any specific information you can provide about your seizures will be helpful.
This might include:
Once your doctor has a clearer picture of the seizures you’re experiencing, they may suggest some tests. These will help them to gather more information for a diagnosis and to rule out other causes, but the tests can’t confirm or dismiss epilepsy on their own.
The tests for epilepsy include:
If you are diagnosed with epilepsy there are a range of treatments available including medication, surgery and stimulation treatments. While epilepsy cannot generally be cured, with the right treatment many people are able to keep seizures under control or even stop them altogether.
Treatment plans are tailored to the individual and depend on their age, the type of seizures they experience and any other medical conditions they may have. You may be asked to keep a seizure diary to give doctors a better picture of your seizures and help them recommend the best course of treatment. This includes simple information such as:
Most people with epilepsy take antiepileptic drugs to help control seizures by altering the chemical levels in the brain.
Antiepileptic drugs are effective for about seven out of ten people with epilepsy. If the first medication is not effective, the doctor may try alternatives or a combination of different types of drugs to find what works best for you.
Epilepsy medications come in capsule, liquid, tablet, and syrup forms and are usually taken daily. Any side effects from these medications should always be discussed with a doctor or pharmacist. Epilepsy drugs can also interact with other medications you may be taking, so they should always be used under the supervision of your healthcare provider.
If you have recently been diagnosed with epilepsy, you may have many questions before starting treatment. It’s a good idea to discuss these with your healthcare provider—you might want to write down a few questions before your appointment.
Here are some examples of questions to ask about your treatment:
In cases where antiepileptic drugs have not successfully helped control seizures, surgery may be considered. First, tests will be carried out to determine whether the seizures are caused by a small area of the brain where surgery is possible.
There are two different types of surgical procedures available:
Other procedures used to treat epilepsy include vagus nerve stimulation (VNS) and deep brain stimulation.
In vagus nerve stimulation treatment, a small electrical device (similar to a pacemaker) is implanted under the chest. Electrical impulses are sent to the brain through the vagus nerve in the neck.
It is unlikely that vagus nerve stimulation will stop seizures completely, but it can help reduce their severity and frequency by altering the electrical signals in the brain. It is often used in combination with antiepileptic drugs.
Deep brain stimulation works in a similar way. Electrodes are implanted in specific parts of the brain where epileptic activity alters electrical signals and helps control seizures. This is a relatively new procedure currently used only in adults, and more research is needed to understand its effectiveness.
The ketogenic diet (also known as ketogenic therapy) is a specialized medical diet that is high in fat and low in carbohydrates and protein. It is sometimes used to treat epilepsy when seizures cannot be controlled with antiepileptic drugs. For this reason, it is more commonly used to treat children, and it has been shown to reduce the number of seizures in some cases.
It is important that children follow the ketogenic diet only under the close supervision of a pediatrician or pediatric dietitian who can ensure that the diet is carefully balanced.
For people whose epilepsy can be triggered by stress, exercise can be useful alongside other treatments. Many people find stress-relieving and relaxation therapies helpful, such as yoga and meditation.
The causes of epilepsy are wide ranging, so there’s no single preventative method, but there are some simple things you can do to help lower your chances of developing it.
For people who have epilepsy, keeping a seizure diary can be an effective method of preventing epileptic seizures as it can help to pinpoint factors that are more likely to trigger a seizure, and allow you to avoid these situations in future.
Certain safety aids can also be helpful in detecting the warning signs of seizures, such as seizure alert systems which monitor things like changes in your heart rate and temperature and send an alert to let someone know you may need help.
While many people with epilepsy respond well to treatment, around 30% of people have uncontrolled seizures that do not respond to medication. For this reason, there is still a lot of research being done to explore new treatments for people with epilepsy. For example, scientists are exploring why gene activity is different in people with epilepsy6 and researching new molecules7 that could potentially be developed into new epilepsy drugs. These findings could be crucial to help discover new medication for people whose seizures do not respond to current treatments.
Epilepsy
Epilepsy
Epilepsy