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What is Epilepsy? on Biteable.

Epilepsy is a chronic neurological disorder. 

When activity in the brain is abnormal it can cause seizures. There are many types of seizures. When you have an EEG the electrical activity in your brain is monitored while having a seizure. This will not only help classify which type you have, it will show where in your brain the seizures originate and potential problems it can cause.

Seizures can be classified by your doctor as generalized or focal which depends on where and how the abnormal activity began. These are just general terms I will be covering, but there are over 40 types of seizures known. You or your loved one may have different types of seizures than what is listed.

Seizures can look like anything from minor twitching of the arms and legs, blank stares, stiffening to shaking of the body, loss of consciousness and much more.

It is important to note that epilepsy doesn’t discriminate and that anyone can be affected by it. 

Are there warning signs?

The short answer is: maybe. Sometimes (not always), those with epilepsy can have what is called auras. Auras can be a symptom that leads to a seizure, which can vary greatly from person to person. General auras that some have however are:

• Anxiety/Fear
• Deja-Vu
• Loss of consciousness
• Nausea
• Confusion

There are many more auras that can happen. They can happen just before a seizure and last anywhere from a few seconds/minutes to a few hours. Most people who experience auras generally have the same ones before a seizure and can have the same type of seizure each time.

What types of seizures are there?

When the abnormal activity in the brain starts, the seizures appear as a result. There are two general types as mentioned previously:

• Generalized: seizures that involve all of the brain.
• Focal: seizures that involve just one area of the brain.

Generalized seizures are described in 6 different terms.

1. Tonic-Clonic. Also known as grand-mal seizures. They are characterized by a sudden loss of consciousness with body shaking/stiffening.  
2. Myoclonic. These appear as brief and sudden jerks of the arms an/ or legs. Loss of consciousness is not always apart of these and a person can remain alert and aware of what is happening.
3. Clonic. Ryhtmic muscle movements that are usually repeated jerking motions. The neck, face, and arms are mostly involved muscle groups affected by this type.
4. Tonic. A stiffening of the muscles in the back, arms, and legs that can cause a fall.
5. Absence. Also known as petit mal seizures. They can appear as a blank stare to small motions like lip smacking or blinking. A person can have a few in a cluster, one after the other. Awareness is usually lost and the person may not know what happened.
6. Atonic. Also known as drop seizures. They are characterized by a sudden loss of muscle control that can cause a collapse or fall.

Focal seizures are described in 2 terms.

• Focal without a loss of consciousness. These can cause a person to experience sudden changes in how things smell, taste, sound, feel and look. Involuntary jerking of arms and legs can accompany them along with dizziness.
• Focal with an impaired consciousness. You can be partially aware or not aware of what is going on during a focal seizure like this. During the seizure, you may stare blankly, respond differently or not at all to your surroundings, and repetitive movements can accompany this. Repeated chewing, hand rubbing, swallowing etc.

What Causes Epilepsy?

Sometimes, there is no known cause for half of the people who are affected by epilepsy. There may never be something that can identify the cause. In others, there are factors/risks that may have played a role in the cause of their epilepsy. For example:

• Head trauma
• Family genetics/influence
• Other neurological/brain conditions
• Developmental disorders
• Infectious diseases
• Stroke
• Dementia

What are the risks of living with epilepsy?

Having seizures can put that person in sometimes dangerous situations. Common concerns are falling that can lead to serious injury. Drowning, as someone with epilepsy there is a higher risk of this than the regular population. Never swim or bathe unattended until you know how you are affected.

Mental health problems are a very serious and real complication a lot of people with epilepsy are at risk for. It can be caused by medication issues, the inability to cope with their own condition and many other factors involved with having epilepsy. Many medications for epilepsy have side-effect warnings about emotional changes that could occur. They are just as serious as any other side-effect and need to be reported to your doctor immediately.

Another main concern is car accidents; seizures can cause loss of consciousness/awareness and can put you and everyone else at risk on the road. Your doctor will evaluate your condition and determine if you are fit to drive. Many states have regulations on drivers with epilepsy, each state has different laws.

Complications during pregnancy. When prescribing anti-epileptic drugs your doctor is required to tell you the risks it can pose to you and your fetus. Planning your pregnancy is different for those with epilepsy. You and the baby will be closely monitored throughout, your doctor should be involved before you decide to get pregnant. Having seizures during pregnancy can be dangerous to both you and the baby.

There are many other risks, and these are just a few. Many people with epilepsy can do most of these things as long as their condition is well-treated and under control. A lot lead normal lives, and this does not mean you can’t do any of these things. Speak to your doctor about your options.

Can epilepsy be life-threatening? 

Along with the complications listed above, there are two other very serious complications that you and your friends/family need to be aware of.

• SUDEP – Sudden unexpected death in epilepsy. There is a risk, in people with epilepsy, that they could die suddenly and unexpectedly. This risk may be small (1 in 1,000 adults and 1 in 4,500 children), but the risk is still there and should be talked about. The person may be healthy at the time which is why it is so unexpected. The only way, at the moment, to reduce the risk of SUDEP is to managed and control seizures. Work with your doctor to for practices/therapies to help manage your seizures. Please use this link to learn more SUDEP.
• Status Epilepticus. If a seizure lasts more than 5 minutes or if you have frequent seizures without regaining consciousness you are at risk of permanent brain damage and death.

How do I help someone who is having a seizure?

Here are some do’s and don’ts of seizure first aid.

Do:

• Pay attention to how long the seizure lasts. If it is longer than 5 minutes the person is at risk of brain damage and death. This is called status epilepticus. You need to get emergency help and be aware of when to give emergency treatment as prescribed.
• Make sure the person is comfortable. Find a safe place for them to sit or lay down if you can. Make sure their head is supported to prevent it from hitting the ground or another hard surface. Remove nearby objects away to prevent any injuries that can occur.
• Check their breathing. If they are lying down put them on their side so their mouth is facing the ground. This will prevent them from choking on their own saliva. During a tonic-clonic seizure, it can look as if the person has stopped breathing due to the muscles in the chest tightening. This will stop and breathing will return to normal when the seizure is over. CPR is not usually necessary or needed during these breathing changes as it will return to normal on its own.
• Remeber to stay calm. Being calm can help the situation immensely, and help the person feel more at ease after the seizure. It can prevent others from interfering, and keep panic at bay. Calmness can create a safe environment. Stay with the person the entire time, and keep track of all of the above so you can be of help.

Don’t:

• Do not hold the person down. Holding them down forcibly does not stop a seizure and the act of restraining can injure the person, cause aggression and confuse them. If they are restrained, they may respond aggressively. They may be walking around during the seizure, let them do so in a safe area that is enclosed. Stopping them can cause agitation. Keep the area safe and controlled during their seizure.
• Never, for any reason, put anything in the person’s mouth. Contrary to popular belief, it is impossible to swallow your tongue during a seizure. If you put an object in their mouth at the time of the seizure they can break the object, choke on it, swallow it or break their teeth. The muscles in the jaw and face tighten during the seizure which can cause them to bite down. If you try to give them food, water or pills when they are not yet fully aware they can still choke. The liquid, food or pills can go into the lungs instead of the stomach. If they are choking, call 911 immediately. 

Always remember to be supportive. For all parties involved, seizures can be incredibly scary. When the person wakes up they could be very confused about the situation, and if you are there be calm and reassure them that they are safe. Explain what happened to them in simple terms once they are cognizant. Stay up to date with your information on epilepsy, terms change and this information is the tip of the iceberg as far as epilepsy goes. There is much more to this condition than what you read.

 

Resources:

A Revised Definition of Epilepsy

Everything You Need To Know About Epilepsy

Tiffany Kairos

Angels of Epilepsy

Living Well With Epilepsy

Seizure First Aid

EEG (Electroencephalogram)