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3d illustration of nerve cells.
3d illustration of nerve cells.

6 Things to Know About Epilepsy

Plus, What to Do if Someone Is Having a Seizure

Epilepsy is a disease of the brain which causes patients to have recurrent, unprovoked seizures. Epilepsy disrupts the brain’s normal electrical functions with abnormal bursts of electrical energy. During a seizure, you may experience loss of consciousness, uncontrollable movements or changes in your behavior or feelings.
Although epilepsy is the fourth most common neurological disease, it can sometimes be hard to diagnose. Epilepsy can be caused by a variety of factors, from genetics to structural changes in the brain.
Whether you or a loved one has epilepsy, Jessica W. Templer, MD, a neurologist specially trained in epilepsy care at Northwestern Medicine, shares the six things you should know about epilepsy and seizures.
1. Epilepsy affects people of all ages.
Epilepsy and seizures can develop at any point in someone’s lifetime. In fact, one in 26 people will develop epilepsy. New cases are most common with younger children, particularly in their first year of life. However, cases also increase after age 55, as individuals are more likely to develop strokes, brain tumors and Alzheimer’s disease at an older age.
2. Seizures are different in everyone.
Each person’s seizure is different. Some can last a few seconds while others can last minutes. It’s important to know that some seizures will have different symptoms, such as numbness, impaired speech and sudden confusion.
Although every seizure is different, there are three main types, defined by the location of impact in the brain:

  1. Focal onset seizures occur in a limited area of the brain. As such, they may cause a single symptom without progression to more complex symptoms, or may only affect one part of the body. For example, if they happen in the part of the brain that controls your right arm, you may notice a sensation or uncontrollable movements in your right arm.
    • During focal onset aware seizures, you are awake.
    • During focal onset impaired awareness seizures, you become confused or lose consciousness.
    • Other symptoms can include déjà vu, a panic sensation, nausea, tingling, numbness, or unusual movements.
    • Sometimes, focal onset seizures can progress to tonic-clonic seizures, which are described below.
  2. Generalized onset seizures affect both hemispheres of the brain.
    • The generalized tonic-clonic seizure, previously known as a grand mal seizure, is part of this group. In this type of seizure, you will undergo three stages.
      • First, you will become unresponsive.
      • You will enter a tonic phase, which results in stiffened limbs.
      • Then, you will experience the clonic phase, which results in jerking limbs.

Eventually, the jerking will stop, and you will regain consciousness. Full recovery after this type of seizure can take minutes to hours. Sometimes, focal onset seizures can progress to generalized tonic-clonic seizures.

    • During atonic seizures, your muscles suddenly become limp.
    • Absence seizures, previously known as petit mal seizures, cause you to momentarily become unresponsive and appear to be staring ahead. These are the most common seizure in children under 14. These types of seizures only last a few seconds.
  1. Unknown onset seizures. When it is hard to identify which part of the brain the seizure started in, physicians classify this type as an unknown onset seizure. Over time and with observation, they may be identified as generalized onset or focal onset. If your loved one exhibits any signs during their seizure, record as much information as you can to help clinicians identify the type.

3. It’s important to know how to provide first aid to someone experiencing a seizure.
Some seizures are more dangerous than others. While there isn’t much you can do during a seizure to stop it, you can protect and help someone. Most seizures stop by themselves within two to three minutes, although there can be a prolonged period of confusion afterwards. For seizures that last longer than five minutes, call for an ambulance.
First, remember to stay calm. If appropriate, lay the individual on their side or cushion their head with a pillow. Once they are protected, call for help and remain with them until they recover. During the seizure, you should never put anything in the person’s mouth. This could cause serious injury. Here are some other things to be mindful of during a seizure.
Things to DO:

  • Do call for emergency assistance when seizures last longer than five minutes.
  • Do safely cushion the person’s head.
  • Do protect the person from any nearby objects.
  • Do time the length of the seizure.
  • Do stay with the person until they recover.

Things you should NOT DO:

  • Don’t put anything in the person’s mouth.
  • Don’t try to move the person.
  • Don’t try to restrain the person.

4. People with epilepsy can give birth to healthy babies.
If you have epilepsy, you can have perfectly healthy pregnancies. It is best to plan your pregnancy in advance so that you can discuss the safest seizure medications and vitamins to take during pregnancy with your care team. Work with your care team before, during and after your pregnancy. Continue taking your medication as prescribed until you consult with your physician. Be sure to discuss all seizure medications with your care team to determine the best care for you. You should also avoid missing medications and any triggers, such as sleep deprivation.
5. Medication can control epilepsy and allow people to live full lives.
Epilepsy is common: More than 3 million people in the United States have epilepsy. With the proper medication and treatment, people with epilepsy can have reduced symptoms and live full and active lives. A multidisciplinary approach, like the one at Northwestern Medicine Comprehensive Epilepsy Center, can help you navigate your disease and maximize quality of life.
6. If medication is not effective, minimally invasive surgery may be an option.
For patients who cannot manage their symptoms with medication, surgery may be the best option. Some patients who previously were not considered candidates for surgery may now be helped through minimally invasive techniques. Stereo EEG can pinpoint the onset of the seizures, and laser ablation may be able to eliminate the part of the brain causing the seizures without needing major surgery.
Another promising advancement in epilepsy care is the use of a responsive neurostimulator (RNS), which acts like a cardiac pacemaker, but in the brain. The RNS is attached to the brain tissue where seizures originate. When it detects an abnormal electrical impulse leading up to a seizure, it provides a pulse of electricity that can prevent a seizure from happening.

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Jessica W. Templer, MD
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