Neurons or nerve cells throughout our central nervous system choreograph our daily function by transmitting electrical and chemical signals to control our every move and thought. In the vast majority of people, these signals and transmissions work in a well-patterned manner, resulting in appropriate movements. For the almost 3 million US adults and children living with epilepsy, these same nerve cells fire their signals abnormally, which results in a seizure. Seizures are sudden, abnormal increases in electrical impulse from nerve cells of the brain.

It is important to remember that not all seizures indicate epilepsy. This is especially true if it is the person’s first seizure or if the seizure is associated with a high-fever illness in children. Many more people may suffer from NES or non-epileptic seizures from various causes.

Epilepsy is often associated only with strobe lighting; however, this is just one of many triggers that can induce a seizure. Each patient suffering from epilepsy may have a slightly different manifestation of the disorder. Some will be more severe than others, as seizures may be caused by different parts of the brain. This is why epilepsy is known as a spectrum disorder, meaning there are many different manifestations and permutations of the disorder.

Epilepsy is typically a lifelong disorder that can only be managed, not cured. However, some patients that receive effective epilepsy treatment may never have another seizure. We simply don’t know enough about the disorder to do more than offer the most advanced and effective treatments currently available.

Who Gets Epilepsy? What are the Causes?

Young and old, male and female, healthy and unhealthy can all develop epilepsy. In fact, in over half of those suffering from epilepsy, there is no known origin. For the other half of patients, the onset of epilepsy can be traced back to one or more of the following causes:

Types of Epilepsy

Because of the breadth of epilepsy as a disorder, it is impossible to group every case under one umbrella term. Different forms of epilepsy are named after the region of the brain in which they originate or by the symptoms they cause. There are about 40 different types of epilepsy and patients may suffer from one or more types. Just a few of the many types of epilepsy follow:

Temporal Lobe Epilepsy is a very common form of epilepsy that typically begins when patients are in their younger years through their teens. These seizures will often affect emotions and senses of smell and taste. Patients may suffer from impaired consciousness as they enter a temporary trance-like state. Those suffering from temporal lobe epilepsy may have difficulty with learning or memory as the hippocampus of the brain is commonly affected by these seizures.

Frontal Lobe Epilepsy is characterized by a focal seizure and often occurs while the patient is sleeping. Patients typically have some loss of awareness and may experience uncontrolled movements anywhere in the body, from their extremities to facial movements.

Absence epilepsy is thought to be a hereditary form of epilepsy that typically begins at a young age and runs in families. Symptoms are typically more mild and can include “staring off into space” or jerking movements that have no specific purpose. Most children with this form of epilepsy will no longer have symptoms after puberty, however some will continue to experience symptoms or develop new seizures into adulthood.

Focal and Generalized Seizures

Focal seizures

Focal seizures are those that can be traced as beginning on one part of the brain. More than half of people with epilepsy have focal seizures to include frontal lobe and temporal lobe epilepsies. During focal seizures, patients may experience an impairment of consciousness or be fully conscious.

Generalized seizures

Generalized seizures are more widespread and occur on both sides of the brain. The consequences of generalized seizures can be very severe as patients often lose consciousness which can lead to falls or other dangerous occurrences. Absence epilepsy and tonic-clonic seizures are two examples of generalized seizures.

Without a proper diagnosis, it may not be possible to know if the patient has focal or generalized seizures. Some patients may develop both with no pattern as to their occurrence. Further, both forms of seizures may have short or longer-lasting effects on the patient and specifically on the functions of the part of the brain from which the seizure started.

Diagnosis of Epilepsy

Diagnosis of epilepsy is rather straightforward and includes:

  • Medical history including family history, medications and any trauma or infections in the past
  • Diagnostic testing using technology such as an EEG (Electroencephalogram), CT or MRI scan and/or MEG (Magnetoencephalogram)
  • Genetic testing, if and when necessary

Can you Prevent Epilepsy?

There is no known preventative measure, medication or procedure that can eliminate the risk of epilepsy. Again, because of the multitude of manifestations and causes of the condition, one cause is rarely pinpointed. In some cases, behavioral changes can reduce the risk of developing epilepsy such as:

  • Reducing the risk of heart disease by maintaining a healthy weight, eating well and exercising regularly
  • Reducing the risk of head trauma by avoiding contact sports and wearing helmets when riding bikes
  • Reducing the risk of brain infection and inflammation by preventing or early treatment of diseases that affect the nervous system such as encephalitis and meningitis

Epilepsy Treatment Program

While we still have no cure, treatment for epilepsy is improving rapidly. Today, more patients than ever have access to life-changing medications and surgical treatments to control their condition. It is estimated that when diagnosed and treated appropriately, upwards of 70% of epilepsy patients can manage their condition effectively. Specialized care at a facility such as Western Neuro can make treatments more effective for those who do not respond well to these therapies alone.

Non-Surgical / Medical Treatment of Epilepsy

Dietary Treatments are the least intrusive approach to epilepsy treatment. Following a strict high-fat and low-carbohydrate diet, also known as the ketogenic diet, may be effective for certain populations.

Medical Therapy consisting of prescription anti-seizure drugs is one of the first courses of action when approaching epilepsy. With almost two dozen drugs with different benefits and side-effects, a consultation with an experienced neurologist is advised.

Surgical & Implantable Epilepsy Treatments

Surgery for epilepsy should be explored when a patient does not receive relief from seizures after two medications, well-tolerated by the patient, are tried. Surgery requires that many important considerations be made and will not be appropriate for all patients. Significant diagnostic testing will be performed to ensure that the focus of the seizure, if any, is pinpointed. Surgical procedures include:

  • Lobectomy / Lesionectomy
  • Multiple Subpial Transection
  • Corpus Collostomy – typically reserved for children
  • Hemispherectomy – typically reserved for children

Implants and Devices can be used when medications are not effective and surgery is not possible. These treatments focus on stimulation of the brain and related functions using electrical current. Some of the latest approved and experimental treatments include:

When it comes to treatment for epilepsy, the neurologists and neurosurgeons at Western Neuro located in Tucson, Phoenix and Goodyear, AZ work together to develop an effective plan to address seizures in a patient-centric and customized manner. Epilepsy treatment is a fluid process that will be different for every patient that comes through our doors.

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