Epilepsy: Frequently Asked Questions (FAQ)

1. What is epilepsy?

Epilepsy is a chronic (long-lasting) medical condition marked by recurrent epileptic seizures. Epileptic seizures are a condition in which brain function is disrupted by excessive or abnormal electrical discharges. Epilepsy can be a neurologic disorder that affects up to 1 percent of Americans.

Different types of seizures can be caused by different epilepsy syndromes. Chronic epilepsy can be caused by stroke or brain tumors. Some causes can be treated by medication while others may require surgery.

2. How can epilepsy be caused?

About 65% people who are newly diagnosed with epilepsy do not have an obvious cause. The remaining 35% are most likely to be due to stroke, congenital anomalies (conditions that we were born with), brain tumours, trauma and infection.

3. What is the best treatment for epilepsy?

The best doctor to treat epilepsy is a neurologist, who has specialized in brain and nervous systems. Many neurologists are specialized in epilepsy diagnosis and treatment. Epilepsy is also treated by many family doctors and internists.

4. What is the diagnosis of epilepsy?

Doctors try to diagnose epilepsy by determining the type and cause of the seizure. Different seizure types are best treated with specific medications. The diagnosis is based on your medical history and a complete physical and neurological exam.

An electroencephalogram, or EEG (Electroencephalogram) may be necessary. An EEG can detect abnormal brain activity and is the only method that can do so. During an EEG, electrodes (small metal disks) are attached to specific locations on your head. To record brain activity, electrodes can also be attached to a monitor. Your doctor may order brain imaging tests such as an MRI or head CT.

To provide information about your seizure details, you should have someone who has seen you many times before, during and after it.

5. What is the treatment for epilepsy?

Epileptic seizures most often can be managed with anticonvulsant drugs. Your age, medical history, health status, epilepsy type, severity, frequency, and type of seizures will all influence the treatment you choose. To choose the most effective treatment, you must first diagnose the cause of your epilepsy.

6. Which precautions are necessary for pregnant women?

As long as they get good prenatal care and are aware of their seizures, mothers with epilepsy can still have healthy children. Women with epilepsy should discuss the possibility of getting pregnant with their doctors.

Birth control pills may not work as well when many seizure drugs are in use. Unplanned pregnancies can result. Unexpected pregnancy should be notified to doctors and women shouldn't stop taking their seizure medications. Sudden discontinuation of seizure medications can lead to frequent, more severe seizures that could be dangerous for the baby.

7. What exactly is epilepsy surgery?

The epilepsy procedure involves the removal of the area of the brain that is responsible for seizures. The epileptogenic area is the location of brain that causes seizures. The epileptogenic zone is identified by neuroimaging and scalp electrical recordings (EEG), as well as clinical signs of seizures. Epilepsy surgery is able to treat epilepsy by removing the source and preventing future seizures.

It is possible to have devices implanted to help with epilepsy. Under the skin is placed a vagus nerve stimulation device (VNS) that stimulates electrically the vagus nervous (which regulates activity between the brain & major internal organs). It can reduce seizure activity for some partial seizures patients. The responsive neurostimulation system (RNS) is a neurostimulator that's placed under the scalp in the skull. A few wires or electrodes connect to the neurostimulator. They are placed at the site of seizures or the top of the brain. This device senses abnormal electrical activity and provides electrical stimulation in order to restore normal brain activity.

8. Are there side effects to epilepsy medication?

Side effects can occur with epilepsy medications, as is the case for all drugs. The severity of side effects will depend on what medication you are taking, how long the treatment is being given, and what type of medicine it is. Side effects are more severe when the dose is higher, but they tend to get less severe as the body adapts to the medicine. To make adjustment simpler, anti-epileptic medications are often started in lower doses. They can be gradually increased to increase their effectiveness.

Some side effects include blurry/double vision, nausea, insomnia, unsteadiness and stomach problems.

9. What are the alternatives to epilepsy treatment?

Studies have examined the efficacy and safety of various treatments for epilepsy. These include biofeedback or high doses vitamin D. The results have been disappointing.