Seizure & epilepsy disorders

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Epilepsy is a neurological condition that affects people of all ages. Also known as seizure disorder, this chronic condition is characterized by recurrent seizures. The cause of epilepsy is unknown in almost 50% of patients, but it could be due to genetics or trauma to the brain.

If you have epilepsy, you’ll receive compassionate care from our experienced, multidisciplinary team that is highly trained in treating seizure disorders. The team may include epileptologists, neurologists, pediatric neurologists, neurosurgeons, nurses and a clinical nurse manager, who are all dedicated to caring for patients with epilepsy.

What is epilepsy?

Epileptic seizures are sudden bursts of abnormal electrical activity in the brain that can cause involuntary movements, changes in behavior and sometimes a loss of consciousness. Epilepsy can result from a wide variety of disorders including brain injury and stroke. Other kinds of seizures are called unprovoked seizures because no cause can be identified. 

Widely regarded as a pediatric disorder, almost one-third of new cases are diagnosed in early childhood. A first seizure requires careful diagnostic evaluation to determine the cause of the event and the most appropriate treatment. Recurrent epileptic seizures can affect neural development in young children and present special challenges to patients and their families.

Types of seizures

Seizure disorders are classified into two groups: generalized seizures, which affect both sides of the brain, and focal or partial seizures, which are localized to one part of the brain.

Generalized seizures

There are two types of generalized seizures:

  • Absence seizures: These seizures are also called petit mal seizures. Absence seizures can cause rapid blinking or a few seconds of staring into space.
  • Tonic-clonic seizures: These seizures are also called grand mal seizures. They can make a person cry out, lose consciousness, fall to the ground and have muscle spasms. The person may feel tired after a tonic-clonic seizure.

Focal onset seizures

Focal onset seizures, also called partial seizures, can cause twitching or a change in sensation such as a strange taste or smell. There are two types of focal onset seizures:

  • Complex focal onset seizures: This type of seizure can make a person confused, dazed and unable to respond to questions or directions for a few minutes.
  • Secondary generalized seizures: These seizures begin in one part of the brain, but then spread to both sides of the brain.

Seizure symptoms

Seizure symptoms can vary significantly. Recognizing a seizure can also be difficult when symptoms are mild. Some seizures involve jerky bodily movements, whereas others may look like the person is daydreaming. Doctors can identify a specific cause for seizures in some cases, but if not, the seizures are known as unprovoked seizures.
Seizures
Common symptoms of epilepsy seizures.

 

Symptoms someone may be having a seizure include:

 

  • Staring into space
  • Rolling back of eyes
  • Unusual repetitive movements such as blinking or head nodding
  • Nausea or headaches
  • Confusion, sleepiness or weakness
  • Feeling tingling, pins-and-needles sensations or numbness in parts of the body
  • Sudden feelings of fear or anger

 

  • Out-of-body sensations
  • Distortions in sense of sight, taste or smell
  • Suddenly falling
  • Involuntary jerking of arms, legs or body
  • Loss of consciousness or lack of awareness
  • Losing control of urine or stool

Most seizures only last a few minutes or less. If you believe someone is having a seizure, and it lasts more than a few minutes, seek medical help immediately. A single seizure or a series of multiple epileptic seizures that last more than five minutes without recovery between is called status epilepticus.

Status epilepticus is a medical emergency that can cause permanent brain damage or death and requires immediate care. Call 911 for help right away if you think someone is experiencing status epilepticus.

Seizure causes & risk factors of epilepsy

In many cases, the exact cause of seizure disorders is unknown. Stroke, head trauma or infection can be the cause in adults, and genetics play an important role in childhood seizures.

Some risk factors that can increase the risk of developing epileptic seizures include:

  • Family history of epileptic seizures
  • Brain malformation such as a lesion
  • Head trauma
  • Brain hemorrhage
  • Lack of oxygen at birth
  • Metabolic abnormality
  • History of stroke

Are you at risk for stroke?

Most strokes are preventable and many of the risk factors are controllable. Our stroke risk quiz helps you estimate your chance of experiencing a stroke, find ways to minimize your risk and get an idea of what to do next based on your results.

Diagnosing epilepsy

The first step in diagnosing epilepsy usually involves a discussion with your primary care provider. They will listen carefully to a description of symptoms and take a detailed medical history. Central to diagnosing epilepsy is determining if there is a precise area of the brain that produces the seizure.

Your doctor may recommend one of several tests:

This test monitors brain wave activity during seizure and non-seizure periods.

This imaging test combines a powerful magnetic field, radio waves and a computer to create highly detailed images of the brain and other organs or body structures and their functions. MRI is the most sensitive imaging technology for the brain, making it a very helpful tool for fine-tuning an epilepsy diagnosis.

This is a noninvasive test that uses special X-ray equipment that captures many cross-sectional views of an organ or area being examined. A computer then combines the many slices to create a two-dimensional view of the organ, tissue or blood vessel for examination. CT scans offer much more detail than traditional X-rays.

This is a type of nuclear medicine imaging that uses a tiny amount of radioactive material to help provide detailed images of internal body organs and structures. Because the PET scan can show body functions including brain activity, it can be a helpful tool for evaluating seizures and other brain disorders.

Epilepsy treatment

Treating epilepsy depends on the type and severity of diagnosis. In some cases, no treatment is given. This is true for specific types of pediatric epilepsy that children will outgrow.

If you are diagnosed with epilepsy, your care team will develop a treatment plan tailored to your needs. The most common treatments for epilepsy are seizure medications, epilepsy surgery and vagal nerve stimulation. Your treatment may also include a low-glycemic diet, also known as a Ketogenic diet, as low blood glucose levels have been shown to control seizures in some people.
 

Medication can be particularly effective in reducing the frequency and severity of seizures, while surgery may be an option for adults or children with a clearly defined focal point responsible for triggering seizures. It’s a successful way to treat seizures in most people. If one medication doesn’t help with your seizure control, your doctor can try a variety of others.

In some cases, surgery such as laser ablation or surgical resection is an option for stopping epileptic seizures. Finding the exact site of abnormal electrical activity is essential before surgical treatment can be considered. Abnormalities located in the temporal lobe of the brain can be treated most successfully with surgery. The surgeon removes brain tissue from the area of the brain where seizures occur, which usually contains a tumor, brain injury or malformation.

Seizures may also be treated using vagal nerve stimulation, a state-of-the-art treatment that has shown to be successful with patients whose epilepsy does not respond to medication. It helps prevent seizures by sending mild electrical pulses to the brain via the vagus nerve. With this treatment, the doctor implants a small device under the skin in the left chest area. A vagal nerve stimulator is sometimes called a pacemaker for the brain because it is programmed to send electric energy at regularly paced intervals to prevent seizures.

Advanced care for epilepsy and seizure disorders

Advocate Health Care provides comprehensive evaluation, diagnosis and treatment for adults and children with epilepsy. We offer the most up-to-date diagnostic tests, including 24-hour, video-monitored electroencephalography (EEG), MRI and a variety of sleep studies to determine the best treatment for each patient. Our physicians are specially trained in surgical resection techniques and leading-edge vagal nerve stimulation, and we participate in trials for new medications.

What you can expect:

  • Proven expertise: Nationally renowned epileptologists affiliated with the Epilepsy Foundation of Greater Chicago.
  • Multidisciplinary team: Epileptologists working closely with neurologists, pediatric neurologists, neurosurgeons as well as your referring physician to determine the best treatment plan.
  • Care for people of all ages: Treating children and adults with all types of epilepsy and seizure disorders.
  • Compassionate support: Education support services for patients with epileptic seizures and their families, plus rehabilitative care.

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