Epilepsy is a common neurological disorder associated with recurrent seizures; however, there also are cognitive, psychological and social aspects to the disease.
Seizures occur when the electrical systems of the brain malfunction temporarily, causing episodes of stiffening and shaking, periods of unusual behavior or sensations with or without loss of awareness.
According to the Centers for Disease Control and Prevention (CDC), an estimated 3 million adults and 470,000 children in the U.S. are affected by epilepsy. However, thanks to advancements in technology and medications, our ability to control seizures and manage epilepsy continues to improve.
“In about half of all cases of epilepsy, there is no identifiable cause,” said Omotola Hope, M.D., board-certified neurologist with Houston Methodist Sugar Land Neurology Associates. “Known causes of epilepsy include genetic and developmental disorders, birth injuries, head trauma, strokes, brain tumors and infections that damage the brain.” Seizure sufferers experience no pain and usually no long-term effects.
Although there are many different types of seizures, doctors have placed them into general categories based on which part and how much of the brain is affected.
Generalized seizures affect both sides of the brain and are characterized by temporary loss of consciousness. There are several types of generalized seizures including: tonic-clonic seizures, absence seizures and focal seizures.
Tonic-clonic seizures, or grand mal seizures, often begin with a fall or cry, then the body stiffens (tonicity); arms flex; legs, head and neck extend; and the jaws clamp shut. Breathing appears difficult, the body jerks (clonicity) and saliva may accumulate in the mouth. Afterward, the person may be confused at first and will experience fatigue from the intense muscle activity.
Absence seizures, or petit mal seizures, most often occur in children and are considerably milder. They may appear as a brief lapse of consciousness while a person stares fixedly at an object, blinking their eyes rapidly or rolling them upwards.
Focal seizures occur when the electrical disturbance affects only a portion of the brain. Focal seizures can be further classified as a focal aware seizure or a focal seizure with impaired awareness. A focal aware seizure may cause sudden jerking on one side of the body, flashing lights in one side of the visual field or an emotional feeling such as fear or anxiety.
A focal seizure with impaired awareness may involve repeating a behavior, such as lip smacking, chewing, swallowing or hand rubbing, and a lack of awareness about one’s environment.
“Antiseizure medications provide an effective treatment for most people living with epilepsy,” said Hope. “Doctors will choose the right medication or combination of medications based on the patient’s age and type of epilepsy with the goal being no seizures and no side effects. For some patients with focal seizures, epilepsy surgery can be highly effective. There are also other therapies that can be explored.”
These include:
- The Ketogenic diet is a strict diet that is high in fats and low in carbohydrates which can be helpful for some children and adults with epilepsy.
- Vagus nerve stimulation involves an implanted device that sends bursts of electrical current to the brain by way of the vagus nerve to inhibit seizures.
- Responsive neurostimulation uses electrodes placed in the part of the brain where the seizure begins, and the electrodes sense the seizure then learn to halt the seizure before it is obvious to the patient.
- Deep Brain stimulation involves implantation of electrodes that send electrical pulses to certain parts of the brain which allow interruption of the seizure network.
To schedule an appointment with Dr. Hope or another neurologist at Houston Methodist Sugar Land Neurology Associates, call 281.274.7595.
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