Epilepsy

What is Epilepsy?

Our brains are made of billions of brain cells that normally work together to control our body's movements, thoughts, memory and feelings. In some people, however, the brain produces abnormal electrical impulses that result in loss of consciousness and uncontrolled body movements or sensation. This is called a seizure disorder, or epilepsy. Epilepsy is simply the tendency to experience recurrent seizures. Two million people in the United States have some form of epilepsy. Thirty percent of those with epilepsy are under 18.

While there is no single cause of epilepsy, any condition that irritates the brain may cause a seizure. Potential risk factors or triggers include injuries to the head, infections of the central nervous system, such as meningitis or encephalitis, brain tumors, stroke, drug overdose or high fevers. No identifiable cause is found in about 70% of all cases of epilepsy.

What are the symptoms of Epilepsy and how is the disease diagnosed?

Epilepsy is diagnosed when people have recurring seizures. There are many types of seizures. Some seizures can be more severe than others and occur more frequently. There is no single test to diagnose epilepsy 100% of the time. Physicians rely on the patient's past medical history, a description of the seizure, a neurological examination and neurological tests called electroencephalograms (brain wave recordings) and magnetic resonance imaging (MRI scans).

The physicians and staff at The Minneapolis Clinic of Neurology, Ltd., have special expertise in the diagnosis and treatment of epilepsy. Click here to access information about The Midwest Center for Seizure Disorders, a very special place that welcomes children and adults with seizure disorders.

There are two major types of seizures: partial and generalized.

Partial Seizures:

A partial seizure occurs when only one part of the brain is affected. Partial seizures come in two types, simple and complex, depending on whether alertness is maintained. Persons with simple partial seizures maintain consciousness while experiencing a wide range of symptoms, such as twitching, sudden jerky movements of one part of the body, nausea, or stomach pain.

Complex partial seizures alter a person's consciousness, leaving them dazed and confused. Persons may make random movements with their arms or legs, mumble, or stare into space. Complex partial seizures usually only last a few minutes. The individual may not remember what happened and may be confused or sleepy afterwards. Sometimes complex partial seizures may spread to involve the whole brain and cause a generalized seizure.

Generalized Seizures:

Generalized seizures affect the whole brain at once. They may affect the whole brain from the onset, or a seizure may start as a partial seizure and spread to involve the whole brain. Generalized tonic-clonic (grand mal) seizures result in a loss of consciousness. Persons may fall, stiffen up and make sudden jerking movements of their arms and legs. The generalized tonic-clonic seizure usually lasts just a few minutes. The individual may then be tired or confused, during what is known as the post-ictal state. These symptoms subside, normal breathing resumes and the person regains consciousness.

Absence (petit mal) seizures occur most frequently in children between the ages of 5 and 15. These seizures are very brief and start and end abruptly. Children may suddenly stop what they are doing, stare into space, or make lip-smacking movements.

Atonic seizures are characterized by loss of muscle tone causing patients to suddenly drop to the ground.

Persons with myoclonic seizures experience brief muscle jerks or twitches. The whole body may be involved, or just the face or arms.

Infantile spasms occur in very young children, and often in conjunction with other signs of brain abnormality.

What are the treatments for Epilepsy?

Although there is no cure for epilepsy, most individuals achieve excellent control with anticonvulsant medications. Carbamazepine (Tegretol), Phenytoin (Dilantin), Valproic (Depakote), and Phenobarbital have been used effectively for many years to control seizures.

Although we experienced a period of over 15 years during which no new drugs for treating epilepsy were developed, new anti-epilepsy drugs, as well as new formulations of the older anti-epilepsy drugs, have recently become available. The newer drugs include Gabapentin (Neurontin), Lamotrigine (Lamictal), Topiramate (Topamax), Tiagabine (Gabitril), Levetiracetam (Keppra), Oxcarbazepine (Trileptal), Zonisamide (Zonegran), and Felbamate (Felbatol). These new anti-epilepsy drugs have resulted in dramatic improvement in seizure control in some individuals with previously uncontrolled seizures.

New technological advances, including the Vagal Nerve Stimulator, an implantable device, have also enhanced seizure control. The very high fat, low carbohydrate ketogenic diet has been shown to have limited effectiveness in controlling seizures in some children. Surgical treatment has improved seizure control in selected patients who are not responsive to medications.

Where can I get more information about Epilepsy?

For more information regarding epilepsy, or to schedule a neurological consultation, please contact our office at 763.588.0661.

For more epilepsy information on the internet, visit the following websites: NINDS, EpilepsyFoundation.org, or aesnet.org.