Carolinas HealthCare System
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10 Questions Commonly Asked to Doctors About Epilepsy
1. What is epilepsy?

Epilepsy is a nervous system (or neurological) disorder in which a person has had two or more seizures that can’t be attributed to another cause. It’s sometimes called seizure disorder and is the third most-common neurological disorder, after stroke and Alzheimer’s disease.

2. What is a seizure?
An epileptic seizure is a malfunction in the brain. The brain controls how the body moves by sending small electrical signals. During a seizure, an overload of signals surges through the brain, spreading to areas those signals are not supposed to be and can lead to convulsions and unconsciousness.

There are several types of seizures. Grand mal seizures cause convulsions and unconsciousness. Lesser-known types can be more subtle. Atonic seizures result in a sudden loss of muscle tone, while absence seizures cause a loss of awareness for short periods of time.

3. If I have a seizure, is that epilepsy?
Most people associate the convulsions of grand mal seizures with epilepsy, but some people have more subtle seizures that don’t cause them to lose consciousness or have uncontrollable muscle spasms. A person with epilepsy may experience subtle behavioral changes or confusion. Others may drift into a trance-like state that’s difficult to break. These symptoms often aren’t recognized as seizures until someone later has a grand mal seizure.

4. What are the risk factors, and can they be controlled?

Risk factors for epilepsy include:

  • Age. Epilepsy is commonly diagnosed in children and older adults.
  • Febrile seizures. If you had seizures caused by high fever during childhood, you’re at increased risk for epilepsy, although having had febrile seizures doesn’t mean you’ll develop epilepsy.
  • Family history. If epilepsy runs in your family, you’re at increased risk.
  • Infections. Meningitis and other infections that affect the brain can raise your risk of epilepsy.
  • Head injuries. Trauma to the brain causes epilepsy in some people. To reduce your risk, wear a helmet when biking, use seatbelts in cars, and wear proper protective equipment when playing contact sports.
  • Stroke. Because strokes affect the brain, they’re sometimes linked to epilepsy. To reduce your risk, eat a healthy diet, exercise regularly, don’t smoke and limit alcohol.
5. What should I do if someone is having a seizure?

If someone near you is having a seizure, do not try to restrain the person or put something in his or her mouth. Contrary to popular belief, a person having a seizure won’t swallow his or her tongue.

You can take steps to help prevent injury, though. Place a pillow or something soft under the person’s head, and move harmful objects out of the way. It’s also helpful to time the seizure. Call 911 if it lasts more than five minutes.

6. What treatments are available, and what are the risks and benefits?
About two-thirds of people with epilepsy are able to control their seizures with medication. Anti-seizure drugs may have side effects like dizziness, weight gain, rashes or fatigue. When medication can’t keep seizures under control, there are alternatives:
  • Doctors may recommend surgery, which can cure epilepsy in many cases.
  • An implanted medical device called a vagal nerve stimulator can reduce the number of seizures by sending electric impulses to the vagal nerve in the neck.
  • A ketogenic diet may be recommended. This is a low-carb, high-protein diet that’s effective in staving off seizures for many children.

7. What’s a common misconception about epilepsy?
Some patients are satisfied their seizures are under control when they have one only every two to three months. In most cases, that’s too frequent, epileptologists say. There are a variety of ways to control the seizures more effectively, including medication and lifestyle changes.

8. Can someone who has epilepsy drive a car?
The laws vary by state. In North Carolina, a person who has epileptic seizures is obligated to report them to the Division of Motor Vehicles (DMV). The DMV’s medical review board decides, on a case-by-case basis, whether the driver is able to drive, taking into account a person’s health and whether the seizures are being controlled by medication or other treatments.

9. Are there common seizure triggers that can be avoided?
Some lifestyle habits can exacerbate seizures. The two most common triggers are alcohol and sleep deprivation. If you have epilepsy, it’s important to avoid alcohol and get enough sleep on a regular basis to keep seizures under control.

Certain medications can also trigger seizures. If your epilepsy was controlled until you began taking new medication, talk with your doctor.

10. What is an aura?
Some people have a sense, called an aura, that they’re about to have a seizure: either an unexplained, knowing feeling or a physical sign, like twitching in a hand or foot. The aura may only last a few seconds, which may not offer someone enough time to prepare for the onset of the seizure by bracing him- or herself or lying down. Only a small percentage of people have auras before their seizures.