Epilepsy is a disorder in which people experience seizures. That’s fairly common knowledge. Beyond that basic understanding, however, is a lot of confusion. For example, many people don’t realize there are different kinds of seizures. Nor are they aware of how to respond to someone who’s having a seizure. Suzette LaRoche, MD, the medical director of the Mission Health Epilepsy Center, breaks down the basics of this condition.
There are different types of seizures.
In all, there are around 12 separate kinds of seizures. However, the three most common types are: generalized tonic-clonic (grand mal), focal (complex partial) and absence (petit mal). Grand mal is the type of seizure most people are familiar with. It’s characterized by stiff, rhythmic shaking, falling and loss of consciousness.
A focal seizure is less dramatic. A person experiencing it might stare or not respond for 30-60 seconds. Or, the person might make sudden, but subtle, movements with their hands or mouth. Absence seizures affect mostly children. They involve a short (10-20 seconds) period of unresponsiveness. Often, children with these types of seizures are misdiagnosed with ADHD. “When someone has a seizure that isn’t typical, it often goes unrecognized,” said Dr. LaRoche.
Epilepsy has different causes.
A person can have a seizure without having epilepsy. For example, a single seizure can result from an alcohol overdose or poorly managed blood sugar. Epilepsy, however, means that a person has recurrent seizures. These seizures can be caused by anything from a head injury to a stroke to a brain tumor, although often there is no specific cause identified. Seizures that present during childhood often have a genetic cause.
Any person can develop epilepsy, but the condition is most common in the very young (often presenting in the first year of life) and in those over age 65. “Epilepsy is caused by a lot of different things,” said Dr. LaRoche. “Many children with epilepsy outgrow it. People who develop epilepsy in adulthood — especially those who have it as a result of a brain injury — generally remain at risk for seizures for the rest of their lives.”
Epilepsy is serious but treatable.
Physical injury is the most common risk of epilepsy. It could be very dangerous for a person to have a seizure while driving, cooking, using machinery, climbing a ladder or any number of other activities. In addition, brain injury, heart abnormalities and even death can occur as the result of uncontrolled seizures.
Fortunately, medication effectively manages seizures in most people with epilepsy. According to Dr. LaRoche, a wide range of anti-seizure medications have become available over the past 10 years. “About two-thirds of people with epilepsy will be seizure-free with the right medication,” she said. “As long as they take it as prescribed, they’ll have normal, healthy lives.”
There are other options available to the one-third of patients for whom medications don’t work. These include surgery, neurostimulation and a ketogenic diet.
You may know someone with epilepsy and not even realize it.
Seizures are the main symptom of epilepsy. In between these events, most people with epilepsy function the same as everyone else. If, however, you ever witness someone having a seizure, there are three important things to remember:
- Despite what you may have seen on TV, you should never put something in the mouth of someone having a seizure.
- Roll the person onto his or her side. This will help prevent choking.
- If the seizure goes on for longer than a minute or two, call 911.
Epilepsy is a stressful condition that can lead to anxiety, stress and depression in those who have it. If you know someone with the disorder, offer your support. “There’s so much stigma attached to epilepsy, but it doesn’t have to be that way,” said Dr. LaRoche. “With the right treatment, those who have it can live happy, healthy lives.”
Suzette LaRoche, MD, is a neurologist and epileptologist at Mission Health Neurosciences.