Epilepsy

by Shayna Bryan, Jaelyn Copeland, Shon Mack, and Senequa Malone | Interns and UAB Community Health and Human Services students

(This article is based on a discussion from WWL’s Monday Night Wellness Watch. [Link to the livestream recording coming soon!])


Epilepsy is a commonly misunderstood illness. Tonight’s conversation explores seizure types, how to recognize seizures, and tips for managing seizure healthWhat is epilepsy?

Epilepsy is a disorder of the brain, also called a neurological disorder, where brain activity becomes abnormal, causing seizures or periods of unusual behavior, sensations and sometimes loss of awareness. These recurring seizures are the single symptom of epilepsy.

People are generally diagnosed with epilepsy when they have had at least two or more seizures within a 24-hour window that are not caused by a known and reversible medical condition.

In the US, there are about 3.4 million people with epilepsy; 470,000 of these are children.

What causes seizures and epilepsy?

Seizures can be caused by many things, some of which and known and will resolve on their own. Some of these conditions are:

  • High fever (febrile seizure)
    • Contact doctor if fever is over 102ºF for children, 103ºF adults
  • Head trauma
  • Very low blood sugar (diabetic seizures)
  • Alcohol withdrawal
    • Alcohol withdrawal syndrome can be very dangerous and even deadly, should be overseen by a trained medical professional

These are non-reversible conditions that can cause seizures, such as any conditions that affect a person’s brain. Some of these causes include:

  • Stroke
  • Brain tumor
  • Traumatic brain injury or head injury
  • Central nervous system infection

However, for 60% of people with epilepsy the ultimate cause is unknown.

Triggers or factors that affect the frequency of seizures:

  • Missed medications
  • Lack of sleep
  • Stress
  • Alcohol
  • Drug abuse
  • Menstruation
  • Photosensitivity (Flashing lights)
    • Affects only 3% of people with epilepsy, despite popularity of depiction in media
  • Nutritional deficiencies
  • Over-the-counter medications

How common is epilepsy? Who is affected?

Epilepsy is the fourth most common neurological disorder and affects people of all ages.

About 1 out of 10 people may have a seizure during his or her lifetime and 1 in 26 will develop epilepsy, so they are fairly common. Seizures can last a few second to several minutes. All age, ethnicities, and genders can develop epilepsy, but it is more common in children and older adults and slightly more common in males.

New cases of epilepsy are most common in children till age 10, then decease and then increase again after age 55.

What do you do if you have a seizure? Is there treatment?

What to do: Go to your regular family physician if you have not already been to the hospital or seen by medical professionals. More information about proper first response to a seizure can be found further down.

For the majority of people, epilepsy can be treated or managed with medications or sometimes surgery to control seizures. Some people require lifelong treatment to control seizures, but for others, the seizures eventually go away. Some children with epilepsy may outgrow the condition with age.

What do seizures look like? What are the types?

Symptoms vary depending on the type of seizure. In most cases, a person with epilepsy will tend to have the same type of seizure each time, so the symptoms will be similar from episode to episode. A mild seizure may be difficult to recognize as it can last a few seconds during which you lack awareness. 

There are two types of seizure, depending on how much of the brain is affected: Focal and Generalized. In both, the person may or may not lose consciousness

  • Focal – Affects part of the brain (can be any part), also called partial seizures.
    • Alterations to sense of taste, smell, sight, hearing, or touch
    • Dizziness
    • Tingling and twitching of limbs
    • Staring blankly
    • Unresponsiveness
    • Performing repetitive movements
  • Generalized – Affects both sides of the brain (the whole brain)
    • Repetitive movements like lip smacking or blinking
    • Muscle stiffness
    • Loss of muscle control (you may fall down suddenly)
    • Repeated, jerky muscle movements of the face, neck, and arms.
    • Spontaneous quick twitching of the arms and legs.
    • Tonic-clonic seizures, (which used to be called “grand mal seizures”) are a type of generalized seizure that is what most people probably imagine a seizure to look like. The symptoms are:
      • Stiffening of the body
      • Shaking
      • Loss of bladder or bowel control
      • Biting of the tongue
      • Loss of consciousness

How does epilepsy affect daily life?

Having seizures and epilepsy can impact one’s safety, relationships, work, driving, and more.

Public perception and treatment of people with epilepsy are often bigger problems than actual seizures. Some people have service dogs that can alert them to an oncoming seizure so they can find a safe place to lie down. People with epilepsy are sometimes burdened with unnecessary medical costs by bystanders who call 911 even when emergency medical help is not needed.

What should you do if you see someone seizing?

Most seizures end in a few minutes, and do not usually require emergency medical attention. If you see some seizing, here’s what you should do:

  1. First, keep yourself and other people calm. If you do not know the person, check or call out to see if there is someone around who can attest to the seizing person’s medical history.
  2. Start a timer. You’ll want to keep track of how long the seizure lasts.
  3. Check to see if the person is wearing a medical ID bracelet or other emergency information.
  4. Clear the area of potential hazards so the seizing person doesn’t hurt themselves
  5. Try to gently ease the person on to their side to help them breathe easier
  6. Only call 911 if one or more of these are true:
    • They have never had a seizure before
    • They have a health condition like diabetes, heart disease, or are pregnant.
    • They have difficulty breathing or waking after the seizure
    • The seizure lasts longer than 5 minutes
    • Another seizure follows soon after the first one
    • The person is hurt during the seizure
    • The seizure happens in water
  7. After it ends, help the person sit in a safe place. Once they are alert and able to communicate, tell them what happened in very simple terms.
  8. Comfort the person and speak calmly.
  9. Offer to call a taxi or another person to make sure the person gets home safely.

ABSOLUTELY DO NOT

  • Hold the person down
  • Try to put anything in their mouth
  • Try to give mouth-to-mouth CPR

Check out these resources to learn more about epilepsy:

Epilepsy Foundation Alabama

(205) 453-8205 / Toll-Free: (800) 626-1582 /  alabama@efa.org
3100 Lorna Road Suite 311
Birmingham, Alabama 35216-5452

Walk to END Epilepsy – Birmingham (November 6, 2021)

Seizure First Aid and Safety Course offered by Epilepsy Foundation (with live webinars hosted in English and Spanish)

Children’s of Alabama – Pediatric Epilepsy Program

UAB Epilepsy Center – Home to Alabama’s only Level IV Epilepsy Center, the highest designation available from the National Association of Epilepsy Centers


Sources:

Centers for Disease Control and Prevention. (2020, September 30). Epilepsy fast facts. Centers for Disease Control and Prevention. Retrieved November 8, 2021, from https://www.cdc.gov/epilepsy/about/fast-facts.htm.

Centers for Disease Control and Prevention. (2020, September 30). Seizure first aid. Centers for Disease Control and Prevention. Retrieved November 8, 2021, from https://www.cdc.gov/epilepsy/about/first-aid.htm.

Centers for Disease Control and Prevention. (2020, September 30). Types of seizures. Centers for Disease Control and Prevention. Retrieved November 8, 2021, from https://www.cdc.gov/epilepsy/about/types-of-seizures.htm.

Mayo Foundation for Medical Education and Research. (2021, October 7). Epilepsy. Mayo Clinic. Retrieved November 8, 2021, from https://www.mayoclinic.org/diseases-conditions/epilepsy/symptoms-causes/syc-20350093.

Pietrangelo, A. (2018, September 17). Epilepsy: Causes, symptoms, treatment, and more. Healthline. Retrieved November 8, 2021, from https://www.healthline.com/health/epilepsy.

Schachter, S. C., Shafer, P. O., & Sirven, J. I. (2013, July). Who gets epilepsy? Epilepsy Foundation. Retrieved November 8, 2021, from https://www.epilepsy.com/learn/about-epilepsy-basics/who-gets-epilepsy.

What is epilepsy? disease or disorder? Epilepsy Foundation. (2014, January 21). Retrieved November 8, 2021, from https://www.epilepsy.com/learn/about-epilepsy-basics/what-epilepsy.

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