Epilepsy

What is Epilepsy?

Epilepsy is a neurological condition of the brain that produces brief disturbances in the normal electrical functions of the brain which causes seizures. That is why epilepsy is sometimes called a seizure disorder.
Someone is said to have epilepsy if they experience two or more unprovoked seizures separated by at least 24 hours or after one seizure with a high risk for more.
Epilepsy is a complex neurological condition that requires more than just a prescription medication as a treatment. I evaluate each person’s case and situation as an individual and work to manage their epilepsy to optimize their long-term health, safety, and independence.
Dr. Lawrence Seiden

Diagnosing Epilepsy

The primary tool for a doctor to diagnose Epilepsy is a detailed medical history with as much information as possible about what the seizure looked like and what happened just before it began.
A secondary tool is an EEG, electroencephalograph. This machine records electronic brain waves via wires taped to a patient’s head. The electric signals from brain cells are recorded as wavy lines by the EEG.
Imaging methods such as CT, computerized tomography, or MRI, magnetic resonance imaging, scans can help a doctor search for growths, scars, or other physical conditions in the brain that may be causing the seizures.

Classification Of Seizure Types

Focal Onset

Aware / Impaired Awareness

Generalized Onset

Impaired Awareness

Unknown Onset

Treatment Options

No Seizures, No Side Effects – that is the goal of Epilepsy treatment
Epilepsy experts, called epileptologists, can help you explore treatment options. Physicians use a variety of methods to treat Epilepsy including drugs, surgery, and special diets. Drug therapy is the most common and usually the first method tried.

Medication

Seizure preventing drugs are also known as anti-seizure drugs or anticonvulsants. They do not work properly until they reach a certain level in the body and that level has to be maintained. There are more than 30 anti-seizure drugs currently approved to treat Epilepsy. About 6 in 10 people may control their seizures with the first or second medicine they try.

Surgery

Certain types of surgery may be used for people whose seizures do not respond to medication. Surgery may be recommended when a seizure focus can be found and removed without hurting vital functions like speech or movement.

Dietary Therapies

Dietary therapies can help control seizures in both children and adults, although they are used primarily in children and infrequently or rarely in adults. They are usually used when seizures do not respond to medicine. The most common diet therapy is the ketogenic diet. This is a medically supervised high fat and low carbohydrate diet. There are other diets that can help control seizures in some people, such as Medium-chain triglyceride diet (MCT), Modified Atkins Diet (MAD), and Low Glycemic Index Treatment (LGIT). Most people who use a diet therapy continue taking medicine.

Responsive Neurostimulation (RNS)

A device to treat seizures that is implanted under the scalp in a small area of the skull or bone surrounding the brain. One or two wires from the device are placed under or on the surface of the brain where seizures start. The device is able to sense a seizure and sends small pulses of electrical current through the wires to help stop or lessen seizures. RNS also may help people who can’t have surgery or when surgery doesn’t work well enough. Like the VNS, the RNS does not cure epilepsy and it may not work right away. Yet it can help stop or lessen the number of seizures a person has by 40% to 60% after one to three years.

Vagus Nerve Stimulation (VNS)

A small device (generator) is implanted under the skin in the left side of the chest. A small thin wire or electrode goes from the generator and is attached to the vagus nerve in the neck. VNS may be an option if surgery doesn’t work or is not right for you. The benefits of the VNS appear to improve over time. For example, about 45% of people have seizures decreased by 50% or more within one to two years.

Deep Brain Stimulation (DBS)

DBS is a newer type of device that also helps control seizures when surgery doesn’t work or cannot be done. Electrode wires are placed in a specific area of the brain. The device is programmed, like VNS, to give stimulation to interrupt or stop seizures.

Understanding & Managing Triggers

Noises

Try using earplugs or headphones in noisy or crowded places. Listen to relaxing music or sounds and distance yourself by singing or focusing on another activity.

Bright, flashing, or florescent lights

Use polarized or tinted glasses. Use natural light indoors. Avoid flickering lights or patterns, such as strobe lights or flashing holiday lights

Sleep

Try to keep a consistent sleep schedule and get enough sleep.

Alcohol / Drugs

Avoid recreational drugs and talk to your doctor about use of alcohol. Avoid alcohol completely if you’re going through high-risk times or have recently had surgery. Consider carefully what you drink and the pace at which you drink it.

Hormonal Changes

Both men and women may notice a cyclical pattern to their seizures. Record seizures on a calendar and track in relation to changes in your hormones. The use of hormonal medicines, such as contraceptives or birth control pills, as well as hormonal replacement therapy, may affect seizures. Be sure to talk to your doctor about all contraceptive use.

Stress, anxiety, or depression

Emotional stress is a common trigger and can be a symptom of mood problems such as anxiety or depression. During stressful times, consider ways to modify your lifestyle and manage stress better.

Communicate with Your Medical Team

When you review your Epilepsy with your doctor, he or she should:

Frequently Asked Questions

Working closely and regularly with your doctor can prevent many seizures. However, there is no guarantee that seizures will not occur. Knowing what may trigger your seizures can help you recognize when a seizure may be coming and help you prepare to lessen the chance.

Seizures in Epilepsy may be related to brain injury, genetics, immune, brain structure, or metabolic cause, but most of the time the cause is unknown.

Some people find that their seizures occur in a pattern or are more likely to occur in certain situations, called a trigger. Examples of triggers are stimuli such as flashing lights or noises, stress, sleep deprivation, alcohol or drug use, low blood sugar, hormonal changes, and caffeine.

A trigger is something that occurs fairly consistently before seizures and more often than by chance. One way to identify triggers is to keep a seizure diary in which you note the time of day, what was taking place at the time of the seizure, describe the environment, and note if commonly reported triggers were present. Share and discuss your seizure diary with your doctor.

Epilepsy does not discriminate. It affects children and adults, men and women, and people of all races, religions, ethnic backgrounds, and social classes. Epilepsy is most often diagnosed in either childhood or after the age of 65, but it can occur at any age. It is the 4th most common neurological disease.

About 3.4 million people in America have Epilepsy. 1 in 26 people in the United States will develop Epilepsy at some point in their lifetime.

Each time a seizure occurs it has the potential to be fatal. People who continue to have seizures are at greater risk of complications, the most serious of which are injuries and dying. One of the more common causes of dying from seizures is known as SUDEP, Sudden Unexpected Death in Epilepsy. In SUDEP, no other cause of death is found when an autopsy is done. This is the leading cause of death with uncontrolled seizures and the best way to prevent SUDEP is to lower your risk by controlling seizures.

No Epilepsy is never contagious. You cannot catch Epilepsy from someone else nor can anyone catch it from you.
For most people living with epilepsy today, the disease can be controlled with available therapies and good seizure-management practices, such as avoiding seizure triggers and including the support of an epilepsy specialist. For people with the most severe types of difficult to control epilepsy, there are steps an individual can take to lower one’s risk, including epilepsy surgery, neurostimulation devices, dietary therapies, and participating in research to find new, more effective therapies.
It’s not unusual for a person to not know what kind of seizure they have. Often diagnosis is based on the descriptions of an observer, which may be incomplete. See an Epilepsy specialist who will evaluate you and recommend a treatment plan.

Get Educated!

We encourage you to explore and learn what resources are available to you to support you and your loved ones through your diagnosis.