Epilepsy is a brain disorder that causes unprovoked recurrent epileptic seizures. It may be due to a lesion in the brain, or it may have a genetic cause. However, in most cases, the cause is unknown, and not all seizures are epileptic seizures. In this article we explain more.
We begin by defining epileptic seizures, which are sudden bursts of abnormal and excessive electrical activity in the brain that can have physical or sensory manifestations. That is, they can cause involuntary body movements, affect bodily functions, cause changes in behavior or altered consciousness.
However, not all seizures are alike. For example, some people with epilepsy have more than one type of seizure, and having a seizure does not necessarily indicate epilepsy. To be clear, a seizure is a specific event, and epilepsy is a neurological disease.
Seizures and their causes
A seizure can be caused by a physical event, disease, or injury, or also as the result of reaction to a substance. Some of the most common causes of seizures are:
- An infection
- A metabolic problem
- Very high fever
- Traumatic brain injury
- A stroke
- Withdrawal from alcohol or some drugs
- Reaction to a medication
In addition, there are also other types of medical problems that may resemble seizures, but are not due to changes in the electrical activity of the brain. Some professionals call them non-epileptic events, including:
- Fainting
- Migraine
- Movement disorders
- Sleep disorders
What is epilepsy?
Epilepsy is a neurological condition characterized by two or more unprovoked seizures. The seizures occur when some nerve cells (group of neurons) in the brain signal in an abnormal way. Epileptic seizures appear intermittently and may last for a few minutes.
In general, we can distinguish two types of epileptic seizures: generalized seizures, which affect the entire surface of the brain and cause loss of consciousness, and partial or focal seizures, in which the discharge begins in a specific area, and can later extend to the rest of the cerebral cortex.
Types of epilepsy
Focal epilepsy
Focal onset epilepsy has the predominant symptom of recurring seizures that affect one half or part of the brain (partial seizures). There are two types of focal seizures: simple and complex.
Focal onset simple partial seizures, also known as focal aware seizures, because the patient remains conscious. Symptoms of these seizures include:
- Sensory changes
- Sudden emotional changes
- Uncontrollable muscular spasms
- Seeing flashing lights
- Dizziness
Complex partial seizures, the patient may appear confused or lose consciousness. Symptoms include:
- Fixed or blank gaze
- Repetitive movements
Generalized-onset seizures
Generalized onset seizures affect the entire brain. There are 6 different types:
- Absence seizures: characterized by a blank gaze, staring into space, and loss of consciousness. There may be minor muscle movements. Absence seizures are more common in children and can be confused with daydreaming.
- Atonic seizures: muscle control is lost. Sometimes you can fall to the ground during this kind of seizure.
- Tonic seizures: muscles stiffen and tense throughout the body
- Clonic seizures: muscles shake continuously for seconds or a minute.
- Tonic-clonic seizures: These are what most people have in mind when talking about seizure. That is, the patient loses consciousness, falls to the ground, and has shaking and muscle spasms for a few minutes.
- Myoclonic seizures: these are characterized by brief muscle spasms, like the response to a jolt of electricity.
Treatment options for epilepsy
Although there are medications to control seizures, for about one-third of the people with epilepsy, medication is unsuccessful. In some cases of patients with drug-resistant epilepsy, surgery may be an option. This surgery aims to find and remove the area of the brain where the seizures originate or remove what may be causing them, such as a tumor.
Surgery for epilepsy is only considered after the patient’s seizures have proven to be resistant to antiepileptic medication, and when the seizures are focal, having their origin in a part of the brain that can be safely removed, that is, when the part of the brain that causes the seizures does not control important functions such as memory, language, or vision, or if the patient has seizures with falling in a way that could lead to further brain injuries.
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Psychogenic non-epileptic seizures
Psychogenic non-epileptic seizures are not caused by abnormal brain electrical activity and have a psychological cause. However, the symptoms appear much like an epileptic seizure. They can cause involuntary changes in behavior, movement, or consciousness and usually last longer than epileptic seizures.
A large portion of people who suffer from this problem have a history of psychiatric problems, such as depression, anxiety, and personality disorders. It is also common for there to be a history of sexual, emotional, or physical abuse or post-traumatic stress.
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