Epilepsy (patient information)

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 * Associate Editor(s)-In-Chief: Jinhui Wu, M.D.

Overview
Epilepsy is a brain disorder that the normal pattern of neuronal activity becomes disturbed. It may be caused by head injuries, stroke and other vascular diseases, brain tumors, brain infections such as meningitis, encephalitis, alcohol abuse, high fevers in childhood, or dystocia when children were born. Symptoms vary depending on the seizure types, from simple staring spells to loss of consciousness and violent convulsions. Usual symptoms include temporary confusion, a staring spell, uncontrollable jerking movements of the arms and legs, even complete loss of consciousness. Electroencephalogram (EEG) is the most common test to diagnose epilepsy. Images studies such as CT or MRI may help find the cause of this disorder. Treatment option of epilepsy depends on the underlying causes. The treatments include anti-epileptic drugs and surgery. Most patients with epilepsy survive outwardly normal lives. But they have to face two life-threatening conditions: status epilepticus and sudden unexplained death.

What are the symptoms of Epilepsy?
Symptoms vary depending on the seizure types, from simple staring spells to loss of consciousness and violent convulsions. In most cases, the patient with epilepsy tends to have the same type of seizure each time.
 * Temporary confusion
 * A staring spell
 * Uncontrollable jerking movements of the arms and legs
 * Complete loss of consciousness

Who is at highest risk?

 * Head injuries
 * Stroke and other vascular diseases
 * Brain tumors
 * Brain infections, such as meningitis, encephalitis
 * Brain poisoning, such as alcohol
 * High fevers in childhood
 * Dystocia when children were born
 * A family history of epilepsy
 * Male

When to seek urgent medical care?
If you experience either of the following symptoms, seeking urgent medical care as soon as possible:
 * First seizure
 * A longer seizure than before
 * Frequently seizures
 * Status epilepticus

Before the patient who's having a seizure is sent to the emergency department, the following measurements may be important and helpful.
 * Keep calm
 * Don't hold the patient, place something soft under the patient's head.
 * Take off any rigid articles from the patient, such as the glasses or backpack, and loosen any tight clothing near the neck.
 * Stay with the patient, observe the event and be able to describe what happened before, during, and after the seizure to the coming ambulancemen.

Diagnosis
The goal of the following tests is to identify the cause of your epilepsy.
 * Neurological physical exam: Your doctor may ask your some conditions on your born, your growth and any head injuries. And, neurological physical exam is needed to detect the possible cause of elilepsy.
 * Blood tests: This is used to check for signs of infections or poisoning.
 * Neuropsychological tests: These tests includes IQ, memory and speech assessments, which help doctors detect the cause of the seizures.
 * Electroencephalogram (EEG): This is the most common test to diagnose epilepsy. It can record the abnormal electrical activity of your brain. The test can help your doctor know what kind of seizures you're having.
 * Computerized tomography (CT): CT scan is also a commmon test for patients with seizure. It can help doctors differentiate the causes of the epilepsy, including brain tumor, trauma, cysts or stroke.
 * Magnetic resonance imaging (MRI): An MRI scan uses magnetic fields but it is a different type of image than what is produced by computed tomography (CT) and produces more detailed images of the body. in the same manner, MRI scan can reveal brain abnormalities that could be the seizures cause.

Treatment options
Treatment option of epilepsy depends on the underlying causes. The treatments include medications and surgery.
 * Ketogenic diet: Clinical observatins show keeping a strict diet that is high in fats and low in carbohydratesome in children may reduce their seizures.
 * Treatment of underlying causes, such as antibiotics for brain infection, surgery or radiation therapy for brain tumor. As the causes of epilepsy are controlled, the seizures may be decreased or discontinued.
 * Medications: The goal of anti-epileptic drugs is to discontiune or decrease the frequency and intensity of the seizures. Many patients can eventually discontinue medications after two or more years without seizures. All anti-seizure medications have some side effects, such as fatigue, dizziness, weight gain or loss of bone density.
 * Surgery: Surgery is commonly recommended to remove a small, well-defined area of the brain that is identified to be related with your seizures. If your seizures originate in a part of your brain that can't be removed, the surgery of a series of cuts in your brain may recommend to prevent seizures from spreading to other parts of the brain.

Diseases with similar symptoms

 * Hyperpyretic convulsion
 * Syncope
 * Cardiac disorders
 * Panic attacks
 * Hypoglycaemia
 * Cataplexy
 * Idiopathic drop attacks
 * Tics
 * Transient ischaemic attacks (TIAs)

Where to find medical care for Epilepsy?
Directions to Hospitals Treating Epilepsy

Prevention of Epilepsy

 * Avoidance of head trauma
 * Keep a healthy lifestyle, avoidance of alcohol abuse
 * Treat high fever as soon as possible for children
 * Avoidance of fetal distress when children born

What to expect (Outlook/Prognosis)?
Most patients with epilepsy survive outwardly normal lives. But some of them, especially children, may develop behavioral and emotional problems. They may be teased by classmates or avoided in school and other social setting. Patients with epilepsy have to face two life-threatening conditions: status epilepticus and sudden unexplained death.