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Learn about epilepsy and seizures, including how epilepsy is diagnosed and treated.

Seizures and epilepsy

What is epilepsy?

Epilepsy is a disease of the brain that occurs when an individual has two or more unprovoked seizures, or a single seizure and risk factors that make it likely that more seizures will occur. An unprovoked seizure is a seizure that is not caused by a reversible medical condition such as low blood sugar or alcohol withdrawal.

More than 2.2 million Americans have epilepsy. In fact, epilepsy is the fourth most common neurological disorder in the U.S., after migraine, stroke and Alzheimer’s disease. Epilepsy can affect people at any age or stage of their life, but occurs more frequently in children under the age of 1 and older adults. Seizures and epilepsy can be serious and lead to injuries, life-threatening emergencies and even death.

If you or someone you know has epilepsy, we can help. 

Allina Health offers comprehensive evaluation and treatment options for children and adults with seizures, including new onset or first-time seizures, and spells of altered consciousness. Patients receive care from specialists with expertise in treating epilepsy, physiological and psychological non-epileptic events, and brain tumors.

Most people can achieve good seizure control through medication or other treatment. If seizures haven’t been controlled after 12 months of treatment, or after trying a second medication, patients are advised to see a specialist. 

A common question I am often asked is, what exactly is a seizure? A seizure is abnormal electricity coming from the brain. Let me give an example. Imagine I'm having a seizure coming from the left side of the brain, which controls the right side of my body. This surge of electricity over the left side of my brain can cause abnormal movements in my right arm, most often jerking movements. So, again, a seizure is abnormal electricity coming from part of the brain that causes symptoms, such as jerking.

Seizures come in many different types. For example, sometimes jerking episodes, some may consist of staring and unresponsiveness. Another common question that we are asked is, do I have epilepsy? Epilepsy is defined as two or more unprovoked seizures.

Let me give another example. A healthy 35-year-old male is at a meeting. For no identified reason, he suddenly collapses to the floor and has a full body convulsive seizure. He recovers after a few minutes. After the first seizure, he does not have epilepsy. If he has a second seizure, then he'll meet criteria to have epilepsy.

Education about what epilepsy is can be very important for many patients and families. Every patient who has seizure activity wants to know the cause. Knowing the cause of the seizure activity is extremely important. Reasons such as stroke, meningitis, or a brain tumor could be the cause of a patient's seizures. Approximately half of patients with epilepsy have no identified cause.

Seizures and epilepsy are common. 9% of the general population will have a seizure during their lifetime. Most people are really surprised to hear that high number. 2.2 million people in the United States have epilepsy. The chance of developing epilepsy is 1 in 26.

It's important to know that care and resources are available for individuals and their families who are affected by epilepsy. Effective treatments that can reduce or eliminate seizures and improve quality of life are available. If you are a family member have been affected by seizures or epilepsy, talk to your doctor for more information about how to access specialized epilepsy care.

Epilepsy is a condition that has several treatment options. It is very important for treatment to be tailored to the individual. For the majority of individuals with epilepsy, seizure medications are used to stop seizures. There are greater than 20 anti-epileptic medications that are currently available.

The goal of treatment is to completely control the seizures with little or no undesirable side effects. Most patients can achieve this goal, no seizures and no side effects. However, approximately one third of people with epilepsy will not have their seizures controlled by medications alone. Seizures that are not controlled within the first 12 months of treatment, or after trying a second anti-epileptic medication, could mean that a person has what is known as refractory or difficult to control epilepsy.

For these individuals, brain surgery or an implanted device may help to control seizures. New advances in technology and surgical techniques are improving outcomes for individuals that have difficult to control epilepsy. If you are someone that you know is having uncontrolled seizures or undesirable side effects from their anti-epileptic medications, talk to your provider about seeing an epilepsy specialist. An epilepsy specialist can discuss and recommend an individualized treatment plan that will not only improve seizure control but quality of life as well.

Epilepsy can negatively impact a person's quality of life in many ways. The unpredictable nature of seizures can be a major problem in school, employment, and, of course, driving. Think about the impact of a child having a seizure in the middle of class. This can be very stressful.

For many jobs, having a seizure can be dangerous. For those who work at heights or around heavy machinery, the risk of injury from seizure activity can be very high. Driving is also restricted in patients with seizures. Driving restrictions are often a huge deal to many patients. Driving restrictions can make it a major challenge to work, take care of your family, or to socialize.

Other important issues for people with epilepsy are problems with depression and anxiety. People with epilepsy have a higher likelihood to develop mood disorders than the general population. Seizures can cause stress, which may contribute to depression or other psychological problems. Also, research suggests seizure activity can lead to chemical changes in the brain, such as hormones and neurotransmitters that could also lead to the development of mood problems.

Individuals with epilepsy often have memory complaints. This is an important issue because doing one's best in school, work, or taking care of family requires your best memory and concentration. There are many factors that can cause memory problems. Seizures and medication side effects are common factors that can significantly impair memory in some individuals with epilepsy.

Recognizing the symptoms of common problems associated with epilepsy and seeking support for them can improve the quality of life of those that face these challenges. There are many resources available that can help people learn to live with and understand epilepsy. Talk to your health care provider for more information on resources for epilepsy education and support.

Epilepsy can affect anyone, regardless of age or gender. It is important that women with epilepsy understand how epilepsy and its treatments can affect reproductive health, including pregnancy. In the United States, there are at least half a million women with epilepsy who are of childbearing age. A majority of these women are able to have healthy and uncomplicated pregnancies.

The two major issues affecting women with epilepsy who are pregnant or considering pregnancy are how epilepsy and seizure medications affect the developing baby and what impact pregnancy has on seizure control. Pregnancy can impact a woman's seizure control. Hormonal changes and other pregnancy-related changes can influence seizure frequency, in part because of their impact on the metabolism of seizure medications. Seizures during pregnancy can worsen, improve, or stay the same.

Studies indicate that for women whose seizures are controlled for at least nine months prior to becoming pregnant, their seizures are likely to remain controlled throughout pregnancy. While some seizure medications can cause problems for a developing baby, there are medications that have been found to be safer to take during pregnancy. These medications are associated with low risk or no risk of serious medical problems or fetal malformations for the developing baby.

Additionally, studies show that women with epilepsy who are of childbearing age can take vitamin supplements, like folic acid, to further reduce the risk of fetal malformations. While certain seizure medications can pose a risk to the development of a baby, not taking seizure medications can result in serious problems for the health of both mother and baby. For most women with epilepsy, the safest strategy for a healthy pregnancy is to continue to take seizure medication.

It is important that women with epilepsy know that it is possible to have a healthy and uncomplicated pregnancy. If you are a woman with epilepsy who is considering pregnancy or who is pregnant, talk to your doctor about seeing an epilepsy specialist. An epilepsy specialist can provide you with the important information and care you need.

More about epilepsy and seizures

A seizure is a disruption of the brain’s normal function caused by abnormal electrical activity that affects the neurons (nerve cells) of the brain. Seizures can cause loss of consciousness, abnormal sensations, movements or behaviors. A seizure is a temporary event that may indicate that there is a problem or disease involving the brain.

There are many types of seizures but they are generally classified as either focal or generalized. Focal seizures begin with abnormal electrical activity in one area of the brain, and are sometimes described by people as “strange” spells or episodes. Generalized seizures begin with abnormal electrical activity involving the whole brain. Seizures vary greatly in their appearance and can affect different people in different ways.

These seizures don’t involve a loss of consciousness or change in a person’s awareness of their surroundings. They may cause different sensations such as a funny taste or smell, cause jerking or twitching of a body part, or cause a change in emotions such as a feeling of fear, dread or even déjà vu.
These seizures cause a person to lose consciousness, feel confusion, or have a change in their awareness of their surroundings. A person having this type of a seizure may stare and not respond or have speech that doesn’t make sense. These seizures may involve purposeless and automatic movements such as chewing, smacking of the lips, rubbing or picking at clothing, humming or repeating words. Following the seizure the person may be tired and not recall the seizure.

Absence seizures are often referred to as petit mal seizures. These seizures are subtle and may involve a brief loss of awareness. A person with this type of seizure may stare blankly or have rapid blinking movements of their eyes and appear to be daydreaming.

Tonic seizures cause the muscles in your back, arms and trunk to suddenly stiffen uncontrollably. These seizures may cause a person to fall suddenly to the ground.

Clonic seizures cause rhythmic jerking of muscles, usually muscles in the hand, arms face and head.

Myoclonic seizures usually appear as large, brief jerks of the upper body, arms or legs. These seizures may cause a person to drop objects.

Atonic seizures, or drop seizures, cause a loss of muscle control and muscle tone. These seizures will cause an individual to suddenly collapse or fall to the ground.

Tonic-clonic or convulsive seizures are often referred to as grand mal seizures. These seizures involve stiffening and shaking of the body and may involve a loss of bladder control and tongue biting. Following the seizure the person is confused and sleepy.

Source: Patricia E. Penovich, MD, Minnesota Epilepsy Group
Reviewed By: Patricia E. Penovich, MD, Minnesota Epilepsy Group
First Published: 04/04/2016
Last Reviewed: 03/25/2016