Epilepsy is one of the most common neurological disease, and it affects more than 50 million people world-wide, according to the World Health Organization. An individual with epilepsy can have unprovoked and reoccurring seizures to the brain.
Epilepsy can develop in any person at any age at any time, but it’s most prevalent in early childhood, adolescents and adults over 55. In the United States alone, people diagnosed with epilepsy represent roughly 1 percent of the population according to the Centers for Disease Control and Prevention (CDC).
“That means that epilepsy is common, says Warren Boling, MD, chairman of the department of neurosurgery at Loma Linda University Health. “Just walking down the street, you probably pass a few people who have epilepsy, but you wouldn’t know because it’s a hidden disease and only manifests when a seizure occurs.”
Today is epilepsy awareness day, and here are six facts you should know about this common neurological disease.
- The Cause Behind It. Epilepsy is caused by abnormal activity to the brain, presenting itself in the form of seizures. Seizures are classified into two groups—generalized and partial. Generalized seizures affect all of the brain at once, while partial seizures start in a region of the brain before usually spreading to affect more regions. There are many different causes behind the seizures. For some, their seizures may be a result of ion channel malfunction, which prevent neurons in the brain from communicating and carrying out normal cell processes. Others can have seizures as a result of scar due to severe head injury, stroke, scarring from infection or brain irritation from tumors. “It’s also important to note that some people who have a diagnosis of epilepsy may not have epilepsy at all,” Boling says. “In people with recurrent spells with alteration of consciousness, we can’t know what those spells represent unless we record an Electroencephalography (EEG) during the spell. We do this in the epilepsy monitoring unit where the patient has EEG recorded usually over several days to see and monitor the actual spells.”
- Common Signs to Spot. Epileptic signs can include long staring spells, uncontrollable jerking movements to one or more parts of the body (hand, foot, and face), and confusion after the seizure is finished. In some types of seizures, consciousness is lost, and in other types of seizures consciousness is retained. “Epilepsy comes in many forms making it complicated to sort out, which is why we have EEG’s and the epilepsy monitoring unit to characterize the specific epilepsy type,” Boling says. “Epilepsy that is uncontrolled with medicine has the potential to be quite dangerous due to the complete loss of control and loss of consciousness associated with most epilepsy types. Serious injury and death can occur if the seizure happens in an unsafe place, and an individual can even drown if they have a seizure near water.”
- Know the Difference Seizure vs. Epilepsy. A seizure is a sudden, uncontrolled electrical disturbance to the brain. Types and severity of seizures vary by how and where they begin in the brain, but most will last a few seconds to rarely a few minutes. “Seizures can arise from severe stress to the brain even in people without epilepsy,” Boling says. “We call these provoked seizures and they can happen to individuals without epilepsy if the right environment is created.” Environments that can result in a seizure include extreme emotional stress, high fever, infections, and sleep deprivation. In order to receive a diagnosis of epilepsy individuals need to have recurrent unprovoked seizures to meet the definition of the disease.
- Seizure & Epileptic First-Aid, What You Should Do. According to the CDC 1 out of 10 people may have a seizure during his or her lifetime. The most important thing according to both the CDC and Boling is ensure that the individual is safe until the seizure passes.
Here are things to keep in mind:
• Seizures that occur in a person with a known epilepsy diagnosis do not usually require emergency medical attention.
• Emergency responders should be called if the seizure lasts more than five minutes or the seizure is associated with other injuries or health risks.
• Avoid putting any medication or objects in the mouth. A person having a seizure cannot swallow.
• Do not hold the individual down or try to alter their movements, unless they’re actively moving towards a dangerous situation such as traffic or a body of water in which case you will need to ensure their safety first.
• Stay with the individual until the seizure ends and they’re fully aware. He or she will most likely be confused after the seizure. Ensure they are alert and able to communicate before you comfort them and explain what happened.
- Can Epilepsy Cause Death? Individuals with epilepsy live full lives when properly diagnosed and controlled. However, in about 30 percent of people with epilepsy, the available medicines cannot fully control the seizures. This is called medically intractable epilepsy and is defined as failure of two or more medicines to control the epilepsy. While rare and not fully understood, some individuals with medically intractable epilepsy can experience sudden unexpected death in epilepsy (SUDEP). The risk of this is much higher in individuals who have uncontrolled convulsive type seizures. “If we can identify treatment options that better control the epilepsy, individuals greatly reduce or even eliminate the risk of SUDEP,” Boling says. “We have seen with earlier treatment for epilepsy, individuals having dramatic functionality improvement and greater quality of life overall.”
- How to treat Epilepsy. The World Health Organization estimates that 70 percent of people living with epilepsy could live seizure-free if properly diagnosed and treated. The problem with this hidden disease is the difficulty to diagnosis. “Often times people will have staring spells described as just being spaced out or out of it. They may not be recognized as epilepsy for some time,” Boling says. “It can often take a more obvious seizure type such as a convulsion for a diagnosis to occur.” Treatment options include medications and surgery. “Right now, there are approximately 18 FDA approved drugs to treat epilepsy,” Boling says. “For individuals who are medically intractable, it is vital that they find effective treatment options. A Comprehensive Epilepsy Treatment Program such as the one at Loma Linda University Health plays an important role in fully evaluating the epilepsy to provide a proper diagnosis and find the best treatment options for the patient.” In the case of medically intractable epilepsy, individuals should seek a referral to a comprehensive epilepsy center where with the help of experts and diagnostic tools the best treatment options can be identified. “If you have been diagnosed with epilepsy and failed two or more medications you should be evaluated in a comprehensive epilepsy program,” Boling says. “The goal of our comprehensive epilepsy program at Loma Linda University is to is to evaluate seizures and spells that people are having, then identify if there is an opportunity to improve and perhaps even cure their epilepsy with various treatment approaches,” Boling says.