Epilepsy Introduction   Epilepsy is not a psychological disorder, but rather a neurological condition that periodically produces short-lived disturbances, or seizures, in the normal electrical conductivity of the brain. [1]  Normal brain function involves millions of tiny electrical charges between nerve cells in the brain to different parts of the body.  Normally, electrical activity occurs in an orderly way, allowing a smooth flow of information to be transmitted.  With epilepsy, this pattern is interrupted by sporadic bursts of electrical energy that are much more intense than usual.  On a detailed level, this disruption is due to improper concentrations of salts within the cell, or over activity of brain chemicals known as neurotransmitters at the site of nerve conduction. [2]  This activity results in altered consciousness, irregular bodily movements, or heightened and unusual sensations, for brief periods of time.   There are several different ways this disorder can manifest.  It is important to note that having one seizure does not necessarily mean that one has or will develop epilepsy. Some can have a single episode and never experience symptoms again.  High fever, lack of oxygen to the brain, episodes of intense stress, over consumption of alcohol, or severe head trauma can all cause seizures.  In order to classify someone as epileptic, the reoccurrence of seizures must be due to some underlying issue that needs to diagnosed. The triggers for these episodes may be present from birth and result from physiological irregularities such as a congenital abnormality.  Triggers may also develop later in life, and be secondary to trauma, injuries, infection, toxic agents, stroke, metabolic disturbances, and sometimes, in approximately 7-10% of people, for reasons that don't have a definitive cause.  It is often recommended to carefully monitor the individual and wait and see if they have another episode, before doing a more extensive workup.  Often thought of as a condition that manifests during childhood, a person can develop epilepsy at any age.  In fact, there is an increasing prevalence of this condition in those over 65 years old. [3, 4, 5]   Seizures can occur in one of multiple parts of the brain.  Where they occur determines the symptoms associated with the episode.  Commonly, there are three phases of an episode, each with associated signs and symptoms.  First, the aura phase, which is pre-seizure, then the ictal phase which is the actual event, and lastly, the postictal phase.  The postical phase follows the seizure where the brain recovers from the event. [6]  There are also different classifications of seizure types, depending on which part and the extent of the brain affected. The two main categories are partial, affecting just one area of the brain, and general, affecting activity throughout the brain. Within these main categories there are subcategories.  Described below are the most common subcategories:   Partial Seizures- The site of origin is a localized area in one side of the brain. Most commonly, these seizures are classified as simple or complex in nature.   Simple Partial: the manifestation of this type of seizure depends on which part of the brain is affected.  For example, if in the motor area of the brain, the person could experience a jerking of the extremities. There is no affect on consciousness in this type of seizure.   Complex Partial: with this type of episode, there is impairment of consciousness, resulting in the inability to respond to, or carry out, simple commands or to execute willed movement, and a lack of awareness of one's surroundings and events.  Automatisms may occur. An automatism is a more, or less coordinated, involuntary motor activity.  A simple complex seizure may begin as a simple partial seizure.   Generalized Seizures- Seizure activity occurs concurrently in large areas of the brain, often in both sides.  Seizures can be convulsive or non-convulsive. The two most common types are tonic-clonic and absence.   Tonic-clonic or grand mal Seizure: During this seizure there is increased muscle tone (rigidity) known as the tonic phase, and then jerking of the extremities known as the clonic phase.  There is loss of consciousness during this type of seizure.   Absence or petit mal Seizure: Occurring most often in children, the loss of consciousness is so brief that it could go unnoticed by the child and the parent.  They usually last about 10 seconds, and while there is no postictal stage, the person is commonly unaware of what happens during the seizure.  It is common from children the ‘grow out' of this type of seizure by adolescence.     Myoclonic Seizure: These seizures are very brief to the point that they may go unnoticed.  They are often confused with tics in that they consist of rapid muscle contractions, but are much quicker that clonic activity.  These seizures occur in all age groups and are associated with other epileptic syndromes. A thorough medical history can provide a lot of insight into determining risk factors and the likelihood of reoccurrences.  Age, family history, and possible causes of the seizure are all taken into consideration when deciding who receives aggressive intervention.  In addition, there are also diagnostic tests that can be used to examine brain activity and give insight into the cause of the irregular brain activity.  Brain function can be monitored by an electroencephalograph (EEG), which involves connecting wires to the skull and monitoring the electrical activity of the brain between episodes.  Scans, such as computerized tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET), can be used to identify growths, scars or other conditions that could be the cause of recurrent episodes.   About 30 percent of the 125,000 new cases every year begin in childhood, particularly in early childhood and around the time of adolescence.  Another period of relatively high incidence is in people over the age of 65.     Epilepsy - Seizure Symptoms   Seizures are the symptoms of epilepsy; the type of seizure can define the type and degree of epilepsy.   Early seizure symptoms (AURA phase) Sensory/Thought: Emotional: Physical: No warning: Deja vu   Smell Sound Taste Visual loss or blurring Racing thoughts Strange feelings Tingling feeling Fear/Panic Pleasant feeling Dizziness Headache Lightheadedness Nausea Numbness Sometimes seizures come with no warning     Seizure symptoms (ICTAL phase) Sensory/Thought: Emotional: Physical: Black out Confusion Deafness/Sounds Electric Shock Feeling Loss of consciousness Odors Spacing out Out of body experience Visual loss or blurring Fear/Panic Chewing movements Convulsion Difficulty talking Drooling Eyelid fluttering Eyes rolling up Falling down Foot stomping Hand waving Inability to move Incontinence Lip smacking Making sounds Shaking Staring Stiffening Swallowing Sweating Teeth clenching/grinding Tongue biting Tremors Twitching movements Breathing difficulty Heart racing     After-seizure symptoms (POSTICTAL phase) Thought: Emotional: Physical: Memory loss Writing difficulty Confusion Depression and sadness Fear Frustration Shame/Embarrassment Bruising Difficulty talking Injuries Sleeping Exhaustion Headache Nausea Pain Thirst Weakness Urge to urinate/defecate *This chart was adapted from epilepsy.com     Epilepsy Statistics   Incidence: In the United States, 181,000 new cases of epilepsy are diagnosed every year.   45,000 children under the age of 15 develop epilepsy each year.   Incidence is highest under the age of 2 and over 65, greater in African American and socio-economically underprivileged populations.  The conditions also affects males more often than females.   The trend shows an increase in elderly populations and a decrease in children.   In 70 percent of new cases, the cause is unknown.   Generalized seizures are more common in children under the age of 10; after this age group, more than half of all new cases will suffer from partial seizures. Prevalence: Prevalence of active epilepsy is about 2.5 million persons in the United States. (Active epilepsy is defined as a history of the disorder including a seizure or use of antiepileptic medicine in the past 5 years).   Prevalence tends to increase with age.   More common in racial minorities than the Caucasian population.   Epilepsy can develop among anyone regardless of age, race or socioeconomic status. [7]   There are roughly 315, 000 school children through age 14 with epilepsy.   There are 600,000 people over the age of 65 with epilepsy. [8] Learn More About Epilepsy Epilepsy Introduction Epilepsy Treatment Products helpful for Epilepsy   Learn More

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