What Is Epilepsy?

Resources We Trust Mayo Clinic: EpilepsyCleveland Clinic: EpilepsyCure Epilepsy: Understanding the Basics About EpilepsyCenters for Disease Control and Prevention: EpilepsyNational Institute of Neurological Disorders and Stroke: Epilepsy and Seizures
Disparities Disparities and Inequities in Epilepsy Black American adults are slightly less likely to have epilepsy than white adults. Meanwhile, Hispanic American adults tend to experience slightly higher rates of epilepsy than either group. Although there aren’t major racial disparities in the numbers of those living with epilepsy in the United States, research suggests there are differences in how racial and ethnic minorities are treated for the condition compared with their white counterparts. This could be due to unconscious bias by healthcare workers or Black and Hispanic Americans being more likely to lack health insurance than their white counterparts, making such care more challenging to pay for. Overall, people in a lower socioeconomic status are more likely to develop seizures and epilepsy, and they may be less likely to receive state-of-the-art diagnostic approaches, to be prescribed antiepileptic drugs, and to undergo surgery to control seizures.e60dc2a1-f33c-4a05-9b50-8e3e8e59762930fa2cf1-461d-43e2-a162-0d4412ef7d7a
Causes Causes and Risk Factors of Epilepsy Common causes, also called etiologies, of epilepsy include these factors:e60dc2a1-f33c-4a05-9b50-8e3e8e597629fc329fb2-34b0-4baf-8f99-24d2bf631d12e60dc2a1-f33c-4a05-9b50-8e3e8e5976297b0f3654-aeaf-435a-8eb5-fa7b77f59b57 Genetic The direct result of a known or presumed genetic difference. Structural Caused by changes to the structure of part of the brain that may be present at birth or come from a head injury, infection, tumors, or stroke . Metabolic When a documented metabolic condition leads to a higher risk of epilepsy. Immune When central nervous system inflammation leads to epilepsy, such as with some kinds of autoimmune encephalitis. Infectious When infections like human immunodeficiency virus , malaria, or tuberculosis lead to epilepsy. Unknown When none of the causes listed above contribute to the cause of epilepsy. Up to half of people with epilepsy don’t know their condition’s specific cause, even with a complete medical evaluation. In some cases, combinations of these categories best describe the causes of seizures. Epileptic Seizure Triggers Epilepsy causes and triggers are different: While seizure triggers don’t cause epilepsy, they can lead to an epileptic seizure in someone who is already susceptible. Common seizure triggers include the following:e60dc2a1-f33c-4a05-9b50-8e3e8e5976296d6ef452-944b-42df-b95d-d27c060d5afb Stress Sleep deprivation Dehydration or missing meals Flashing lights Consumption of or withdrawal from alcohol or drugs In most cases of childhood epilepsy, causes are genetic, metabolic, or a structural issue present at birth. Epilepsy in adults is more likely to be caused by structural changes acquired over time, like tumors or strokes.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b700a50d-7adf-4c55-81ff-36ba4b1e027b
Lifestyle Lifestyle Changes and Prevention of Epilepsy and Seizures It isn’t possible to prevent all forms of epilepsy, but you can take some steps to reduce your risk of developing the condition.e60dc2a1-f33c-4a05-9b50-8e3e8e59762978408e73-d6e7-410f-bbed-6bd27a6f2c8f Practice Good Hygiene to Prevent Infection An infection called neurocysticercosis is a common cause of epilepsy globally, and it comes from ingesting tapeworm eggs. It’s most common in areas of Latin America, Asia, and Africa with poor sanitation, but fairly uncommon in the United States and Europe. You can reduce your risk of infection by practicing good personal hygiene — such as washing your hands regularly — and using safe food preparation practices, including regularly cleaning surfaces in your kitchen.e60dc2a1-f33c-4a05-9b50-8e3e8e597629301952e9-763c-4032-944d-e276c14b3471 Protect Your Head and Brain From Injury Another common cause of epilepsy is traumatic brain injury or head injuries. You can reduce your risk for head injuries by wearing a helmet when playing sports such as hockey or when riding a skateboard or bicycle, for example. Wearing seatbelts while riding in the car and making sure to use child safety seats for babies and younger children can also help. Reduce Cardiovascular Disease Risk Factors Reducing your risk of heart attack and stroke can also help lower your risk of developing epilepsy later in life, as some epilepsies are caused by these health events. A heart healthy diet , regular exercise, and managing stress can help you maintain heart and blood vessel health. Once you receive an epilepsy diagnosis, the best way to prevent seizures and reduce their frequency is to stick with the treatment prescribed by your doctor. If you feel your treatment isn’t working and seizures are affecting your quality of life, talk to your doctor about other options.
Symptoms Signs and Symptoms of Epilepsy Seizures are the best-known symptom of epilepsy . Symptoms of epileptic seizures vary widely depending on which type of the brain they involve, how much of the brain they impact, and the severity of the impact. Because of this, seizures can range from relatively benign events to life-threatening emergencies. Doctors classify seizures as generalized, focal, or unknown based on where in the brain they start and the extent of their activity in the brain. Many subtypes of seizures exist in each of these categories.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291ab16d6d-121c-4b56-95c4-ade53287ce27 Generalized Seizures In generalized seizures, the abnormal neuronal activity spreads across both halves, or hemispheres, of the brain. Generalized seizures have both motor (movement) and nonmotor (absence) symptoms.e60dc2a1-f33c-4a05-9b50-8e3e8e5976290e2a6dba-4dcc-4afa-9021-97de02798409 Generalized seizures include these examples:e60dc2a1-f33c-4a05-9b50-8e3e8e597629b8dd5707-6071-4d58-a688-f10410dee2c6 Absence Seizures Absence seizures may last only seconds and are sometimes confused with daydreaming, as the person is usually unresponsive during the seizure. Atonic Seizures These seizures cause normal resting muscle tension, or tone, to go limp. This can look like suddenly slumping over or dropping to the ground. Myoclonic Seizures These seizures are sudden body jolts or increases in muscle tone that make it seem as if the person has been jolted with electricity. Tonic Seizures In this kind of seizure, the person’s muscle tone suddenly stiffens, and they lose consciousness. They may also fall to the ground, but in a rigid manner, more like a tree trunk than a rag doll. Clonic Seizures This type of seizure causes a person’s muscles to spasm and jerk. The muscles in the elbows, legs, and neck flex and relax in rapid succession. Tonic-Clonic Seizures Previously known as grand mal seizures, these are the kind of convulsions people often associate with epilepsy. The person becomes rigid, then muscle jerking begins. Focal Seizures Focal seizures start in one part of the brain and stay in just one brain hemisphere. Because of this, symptoms aren’t often as extensive as generalized seizures. Focal symptoms tend to involve only one side of the body instead of both. Many focal epilepsies have an “aura,” or warning symptoms of an upcoming seizure. The person experiencing the aura is conscious. Focal seizure symptoms come in different categories:e60dc2a1-f33c-4a05-9b50-8e3e8e59762932b14486-5d0b-4001-a194-1e17844bc4c9 Motor These symptoms often involve jerking movements of a foot, the face, an arm, or another part of the body. Sensory Sensory symptoms can affect hearing or sense of smell or may cause hallucinations. Autonomic These symptoms affect the part of the brain responsible for involuntary functions, causing changes in blood pressure, heart rate, or bowel or bladder function. Psychic When a focal seizure strikes parts of the brain related to emotions or memories, it can cause feelings of fear, anxiety , or déjà vu. You can also tell the difference between focal seizures by the level of awareness involved:e60dc2a1-f33c-4a05-9b50-8e3e8e59762910b701fe-7998-44c6-ac7c-c5809101ee26 Focal Aware Seizure During a focal aware seizure, the person is awake but frozen and unable to respond for a few seconds up to a couple of minutes. They will be able to recall the seizure afterward. Focal Impaired Awareness Seizure This kind of seizure causes a lack of awareness. The person may perform actions without realizing what they’re doing. They may seem like they are daydreaming but can’t be startled out of it. Focal to Tonic-Clonic Seizure Some seizures start as a focal impaired awareness seizure and progress to a generalized tonic-clonic seizure, affecting both sides of the brain. Combined and Unknown Seizures Some epilepsies include both focal and generalized seizures, particularly some of the syndromes of early childhood, such as Dravet syndrome and Lennox-Gastaut syndrome.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299510652a-d8f0-456b-851f-5caf3fed1826 Sometimes doctors also classify seizures as “unknown onset” when diagnostic tests are inconclusive or unavailable.e60dc2a1-f33c-4a05-9b50-8e3e8e59762992c10c97-bc7d-45b4-a5ba-60e336b00ac7
Complications Complications of Epilepsy With early diagnosis and treatment, most people with epilepsy can go on to live long and healthy lives. But in rare cases or without treatment, it can cause complications — some of which are fatal. Complications of epilepsy, as well as conditions that commonly occur alongside it, include these examples.e60dc2a1-f33c-4a05-9b50-8e3e8e59762970f55879-140c-418f-be41-9eb9f83212f1 Accidents People with epilepsy are also at increased risk for accidents — burns, car accidents, drowning, falls — that occur during or immediately after a seizure. Antiseizure Medication Side Effects Some antiseizure medications cause side effects. Milder side effects can include rashes, concentration issues, and fatigue, while severe side effects may include severe rash, thoughts of suicide, or liver inflammation.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299ae2caad-6a28-449c-a057-183a3d3e0cfa Sudden Unexpected Death in Epilepsy (SUDEP) SUDEP is the leading cause of death for people who experience seizures — about 1 in 1,000 people with epilepsy die from SUDEP each year.e60dc2a1-f33c-4a05-9b50-8e3e8e59762961a6e191-6777-4a91-8337-7b081cfd65a0 In many SUDEP cases, an otherwise healthy person with epilepsy is found with no evidence of having had a seizure. Status Epilepticus Status epilepticus is a rare, but life-threatening condition in which a single seizure or multiple seizures last for more than five minutes, causing lung, heart, or neurological complications that may be fatal for anywhere from five to 40 percent of those who experience it.e60dc2a1-f33c-4a05-9b50-8e3e8e5976292fb32994-8bab-4d0a-ae89-518c83f50c1b Attention-Deficit/Hyperactivity Disorder (ADHD) Up to about 3 in 4 children with epilepsy may show signs or symptoms of ADHD . Most children with epilepsy and ADHD have difficulty paying attention or focusing, rather than hyperactivity.e60dc2a1-f33c-4a05-9b50-8e3e8e59762988e6d533-821f-4858-9d52-f6d388b9b7a7 Migraine People with epilepsy may be up to twice as likely to experience headaches caused by migraine , and the two conditions may share some genetic roots. Epilepsy can also cause other types of headaches .e60dc2a1-f33c-4a05-9b50-8e3e8e597629a5ffb66b-4281-4a90-84d5-614f9ba3e393 Epilepsy, Stigma, and Mental Health Some evidence suggests people with epilepsy experience higher rates of depression and anxiety than the general population. In addition, people with epilepsy are 2 to 5 times more likely to die by suicide. This may be due to the stress of managing the condition or because of the social stigma surrounding epilepsy.e60dc2a1-f33c-4a05-9b50-8e3e8e59762934dcd082-4c01-4ef1-9bb7-f2cb19e008ea Historically, people who experienced seizures were linked with witchcraft and demonic possession, among other folk beliefs. These beliefs and the stigma attached to them still affect people with epilepsy in some parts of the world.e60dc2a1-f33c-4a05-9b50-8e3e8e59762920f5e6d4-64b6-4c10-9b30-02659c20f944 Epilepsy can also be isolating , for children and adults. Friends, family, colleagues, and neighbors may not understand the condition or know how to respond when you have a seizure. Also, if those with epilepsy can’t drive, it can make accessing friends and family more difficult.
Prognosis How Long Does Epilepsy Last? How long you will experience epilepsy symptoms depends on the type of epilepsy you have and what’s causing it. While medication helps some with epilepsy, it doesn’t have the same effect on everyone: Nearly half of people with epilepsy will be seizure-free after using the first seizure medication they try.e60dc2a1-f33c-4a05-9b50-8e3e8e5976297a888474-940d-4ce0-ab4e-9e1a787b3d72 Another 14 percent of people may become seizure-free after trying a second or third medication.e60dc2a1-f33c-4a05-9b50-8e3e8e5976297a888474-940d-4ce0-ab4e-9e1a787b3d72 About 30 to 40 percent of people with epilepsy have seizures that don’t respond to medication.e60dc2a1-f33c-4a05-9b50-8e3e8e5976290c3169ba-5bcd-4150-aef5-c983e3f83b83 Additionally, over 6 out of 10 children with epilepsy outgrow the condition.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299a6c1c97-74b5-4374-acde-293a3b037d4e Most doctors will consider lowering your dose or even discontinuing your seizure medication if you’ve been seizure-free for two to four years. But many people with epilepsy will need to remain on medication for longer periods to keep their symptoms under control.e60dc2a1-f33c-4a05-9b50-8e3e8e5976292502a9a1-73da-42d1-a2cb-7b0f7b5d0415
Diagnosis How Is Epilepsy Diagnosed? A variety of tests can help find evidence of and diagnose epilepsy, as well as rule out other possible seizure causes. One of the main tools used for diagnosing epilepsy is the electroencephalogram, or EEG. An EEG records the brain’s electrical activity and can reveal the abnormal electrical brain activity that causes epilepsy. Sometimes brain imaging using MRI or computed tomography (CT) can also identify structural brain abnormalities that may be causing seizures. Your medical history also provides important clues to the underlying cause of seizures.e60dc2a1-f33c-4a05-9b50-8e3e8e5976291da18958-36af-4bbd-80d1-4f840741d577
Treatment Treatment and Medication Options for Epilepsy Antiseizure medication and anti-epileptic drugs are firstline treatments for epilepsy . Options including neurostimulation and surgery, as well as complementary therapies, can also help in some cases. Medication Most people with epilepsy can become seizure-free by taking an antiseizure medication. Some may need to take a combination of medications to control their seizures. Your doctor will likely prescribe a single medication at a relatively low dose to start, increasing the dose gradually until your seizures are under control. More than 20 antiseizure medications and anti-epileptic drugs exist, including the following types:e60dc2a1-f33c-4a05-9b50-8e3e8e5976295be6de17-bd75-405e-a0ba-b5e068958424 brivaracetam clobazam clonazepam carbamazepine gabapentin lacosamide lamotrigine levetiracetam lorazepam oxcarbazapine topiramate valproic acid zonisamide Evidence also shows cannabidiol (CBD) can help reduce seizures for children with certain epilepsy syndromes.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e479941f-45e8-45c9-b50b-834007c22df1 To help you find the right medication, your doctor may consider these factors: Your specific condition The frequency of your seizures Your age Co-occurring or pre-existing health conditions Other medications you’re currently taking
Epilepsy is a chronic neurological disorder in which the normal chemical and electrical activities between nerve cells in the brain, or neurons, become disturbed. This disturbance causes the neurons to fire abnormally, resulting in seizures. During a seizure, many neurons fire at the same time, much faster than usual.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f310eb6a-cb73-4875-bfdb-3f86626d4a46 About one percent of U.S. adults have active epilepsy, meaning they have a diagnosis and either take medication for the condition or have had a seizure in the past year. e60dc2a1-f33c-4a05-9b50-8e3e8e5976294f10636a-490a-4bdc-ae8a-2933620b75ba While epilepsy isn’t curable, it’s possible to manage the condition with treatment options like medication and lifestyle adjustments.
Surgery More than half of people newly diagnosed with epilepsy will become seizure-free with their first medication. If anti-epileptic medications don’t work, your doctor may recommend surgery. Surgery may help if brain scans reveal that your seizures originate in a small, well-defined area of your brain, and removing it won’t interfere with speech, language, motor function, vision, or hearing. Even after successful surgery, some people may need to keep taking an antiseizure medication to prevent seizures, but it’s often fewer drugs at lower doses.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296d785fc9-9ace-4f5c-8531-5e9c74a4b5fd Neurostimulation An alternative to surgery for some people with epilepsy is neurostimulation, which uses electrical pulses to stimulate the vagus nerve or other parts of the brain to stop or prevent seizures. Types of nerve stimulation include the following: Vagus Nerve Stimulation A device called a vagus nerve stimulator sends pulses of electrical energy through the vagus nerve to your brain, reducing the number and severity of seizures.e60dc2a1-f33c-4a05-9b50-8e3e8e597629651e1722-14ad-4b68-9476-fb59eb493330 Deep Brain Stimulation A neurosurgeon implants electrodes into a specific part of your brain, usually your thalamus. The electrodes are connected to a generator implanted in your chest or your skull, and they send electrical pulses to your brain to control seizures.e60dc2a1-f33c-4a05-9b50-8e3e8e59762911b84406-7a48-4691-aa9d-cf9ef58c92ef Responsive Neurostimulation An implantable, pacemaker-like device could help stop seizures by detecting them before they occur and delivering an electrical charge to the affected area of the brain to stop them.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f11890e7-6f65-42d8-8d00-f883631f1c3b Complementary and Integrative Therapies Some people with epilepsy also try alternative and complementary therapies alongside traditional treatments: Acupuncture A traditional Chinese treatment in which a practitioner inserts thin needles into your skin at various points around your body, acupuncture could reduce seizure frequency in some people.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296a5f0ee6-0a8b-4c9b-8903-9e735979e747 Vitamin E Some studies have shown that people on anti-epileptic drugs who also take vitamin E supplements have fewer seizures and fewer signs of epilepsy on brain electroencephalograms.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a55102a6-adf8-4068-980b-18799f718b5e Ketogenic Diet Evidence suggests the keto diet — a high-fat, low-carbohydrate approach — could help control seizures for some children with epilepsy, but it’s important to follow the diet under the guidance of a doctor.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c88d87ac-07f6-4ca2-884a-f3aed07bf2bc
Types Types of Epilepsy Some forms of epilepsy are defined by a set of symptoms that mark them as a “syndrome.” In other cases, we define types of epilepsy by which part of the brain it involves or affects. Epilepsy Syndromes Dozens of epilepsy syndromes exist. While some can occur alongside or lead to developmental delays, others don’t affect cognitive development.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b8f6bd97-4b0b-4b05-8a9b-e60cc14317ad Some of the most common epilepsy syndromes include these conditions: Childhood Absence Epilepsy (CAE) People with this epilepsy syndrome have staring spells that last 10 to 20 seconds and then end abruptly.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295756193d-0013-43d8-9541-d87a370d117b CAE often responds to medical treatment and typically disappears by adolescence.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b8312e0e-90d3-4539-acf6-bf2dbfd6ff28 Juvenile Absence Epilepsy (JAE) JAE seizures tend to last longer than CAE seizures and can also involve generalized tonic-clonic seizures, which affect movement. While it often responds to treatment, both the condition and treatment tend to be lifelong.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f6f6e344-7fc9-46ee-ad50-53159468d5b2 Juvenile Myoclonic Epilepsy (JME) People with JME can have absence seizures, myoclonic (muscle-jerking) seizures, and generalized tonic-clonic seizures. Kids can grow out of JME, but most will need to take medication throughout their lives.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d58fd6ca-e326-4e9b-9c04-f4bd2d40ae03 Benign Childhood Epilepsy With Centrotemporal Spikes The most common epilepsy syndrome in children, this type of epilepsy involves facial twitching and numbness, and the seizures often occur at night. For most children, seizures cease by age 15.e60dc2a1-f33c-4a05-9b50-8e3e8e597629dfd82355-9044-4426-80ce-2b2ff581185d Another group of epilepsy syndromes include those directly related to or triggered by sleep.e60dc2a1-f33c-4a05-9b50-8e3e8e597629fd4f93ef-3584-4889-b953-61d4463604da Additionally, reflex epilepsy syndromes are rare conditions involving seizures triggered by sensory or cognitive factors.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b80cf307-2ed6-4a31-98d1-b084c249c106 Epilepsies Based on Brain Region Because different parts of the brain perform different functions, seizure activities in different areas can have distinct symptoms. Here are some examples of epilepsy syndromes by brain regions affected: Temporal Lobe Epilepsy (TLE) TLE often has an aura of déjà vu, fear, an unusual smell or taste, or gastric rising, a sensation in your stomach similar to being on a rollercoaster. A TLE seizure can look like a staring spell or cause repetitive behaviors called automatisms.e60dc2a1-f33c-4a05-9b50-8e3e8e597629272db46f-cd97-4ce5-aa9d-7f4b02a7b284 Frontal Lobe Epilepsy Someone with frontal lobe epilepsy may have muscle weakness and abnormal movements, like twisting, waving the arms and legs, or grimacing during seizures, as well as psychosis , loss of awareness, personality changes, or different-than-usual behaviors. These seizures often occur during sleep.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a8fe3d9d-a9ed-4b83-8fab-e6f616ec49b3 Neocortical Epilepsy This type of epilepsy affects the neocortex, or the outer layer of the brain. Seizure symptoms can vary from unusual sensations to visual hallucinations, emotional changes, or convulsions.e60dc2a1-f33c-4a05-9b50-8e3e8e59762914f0aab1-db61-4c64-b087-6dce50b64b54 Occipital Lobe Epilepsy This rare type of epilepsy involves recurring seizures originating in the part of the brain responsible for vision. Seizures tend to include visual changes, such as flashing lights, or even hallucinations.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299ac70a4f-ae37-484e-9d55-3308aa2f7cdb
The Takeaway Epilepsy is a condition that causes seizures, and its severity can vary from mild to life-threatening based on the type of epilepsy you have. Antiseizure medications are the standard treatment for epilepsy and allow many people with the condition to live seizure-free. While seizures can seem frightening and in some cases are dangerous to the person experiencing them, epilepsy is often very manageable with help from a healthcare professional.

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