Many people have seizures. Here's why that doesn’t always mean epilepsy.
The unpredictable, debilitating nature of a seizure can be frightening, for both the person experiencing it and any loved ones watching nearby.
In that moment, control often slips away as muscles stiffen, limbs jerk, awareness fades into confusion or blankness and those around feel powerless to help. At the same time, "the image that comes to mind of a person convulsing and shaking their whole body is only one kind of seizure,” explains Dr. Austin Wang, director of adult epilepsy at NYC Health + Hospitals/Bellevue Hospital Center in New York. In reality, other seizures can look quite different – sometimes appearing as nothing more than a brief pause in speech, a vacant stare or small, repetitive movements like lip smacking or blinking.
Regardless of the type, fear of recurrence often lingers long after the episode ends. And that fear isn’t unfounded as research shows nearly one in 10 people will experience at least one seizure during their lifetime.
The unpredictable, debilitating nature of a seizure can be frightening, for both the person experiencing it and any loved ones watching nearby.
Fortunately, for most of these people, this is a single, isolated event. But for those diagnosed with epilepsy, seizures are recurrent and often unpredictable.
Here’s what epilepsy is, what causes it and how it’s treated if it affects you or someone you love.
What is epilepsy? How is epilepsy different from a stroke?
Epilepsy is a chronic neurological disorder in which the brain produces recurring, unprovoked seizures – episodes of abnormal brain activity that cause involuntary changes in bodily function, sensations or awareness. Epilepsy diagnosis is typically made after two or more seizures but can also be made after only one, if the risk of recurrence is deemed high. “It is estimated that one in 26 people will develop epilepsy during their lifetime, which is why awareness is so crucial,” Wang says.
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Whether someone has epilepsy or their seizure is an isolated experience, symptoms of a seizure vary depending on where in the brain the abnormal activity began and how far it has spread.
“The primary distinction between epilepsy and seizures is recurrence,” explains Dr. Jerry Shih, director of the Comprehensive Epilepsy Center at the UC San Diego School of Medicine. “A seizure is a one-time vascular event that causes brain damage, while epilepsy reflects an ongoing predisposition to recurrent seizures.”
What causes epilepsy?
One of the most common causes of epilepsy is a structural brain abnormality. “Epilepsy can result from structural issues in the brain, such as brain tumors, brain injuries, brain infections or congenital malformations,” says Shih.
Other causes include metabolic disorders, brain infections like meningitis or encephalitis, birth-related oxygen deprivation and genetic mutations that alter how brain cells communicate.
“Head injuries or traumatic brain injuries can also increase the risk of developing epilepsy,” adds Shih. He also notes that exposure to certain toxins or substances can similarly provoke seizures and that, in some developing countries, parasites are another leading cause.
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Sometimes scar tissue from prior brain injuries or surgeries can also disrupt normal electrical signaling − a condition known as secondary epilepsy.
Other times, no specific cause can be identified. “There are times we may not have a clear cause, despite thorough imaging and testing,” Wang says. When that happens, the condition is called idiopathic epilepsy.
How is epilepsy treated?
While there’s no universal cure for epilepsy, with proper treatment, many people diagnosed with the condition achieve long-term seizure control and lead full, active lives.
The first line of therapy is usually medicinal − specifically, anti-seizure medications (ASMs) that regulate or suppress abnormal brain activity. “ASMs can effectively control seizures in about two-thirds of all patients with epilepsy,” Shih says. Some such patients may eventually “be cured of their epilepsy and be altogether free of anti-seizure medications,” Wang adds, “but for the most part, patients need to remain on them long-term.”
For people whose seizures persist despite medication, other options include brain surgery to remove or modify the affected area or implantable neurostimulation devices that help regulate brain signals.
Lifestyle habits also play a powerful role. Avoiding injury by "wearing a helmet when cycling and maintaining a lifestyle that supports heart and brain health can help lower risk,” Wang says. “Smoking and illicit drug prevention, regular exercise, a healthy diet and seeing your primary care doctor regularly are other simple steps we can take."
And if you're prone to seizures, it's also important to maintain a consistent sleep pattern, manage stress and to avoid known triggers such as flashing lights, loud noises, dehydration, alcohol consumption or hot or cold extremes in order to diminish frequency. As the saying goes, Wang notes, "an ounce of prevention is worth a pound of cure.”
Source: This article originally appeared on USA TODAY: What is epilepsy? Seizure symptoms and treatments, explained