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What is epilepsy?
What causes epilepsy?
Brain injury or disease
How is epilepsy diagnosed?
How is epilepsy treated?
What is the outlook?
What is epilepsy?
Anyone can have a seizure if the brain is exposed to a strong enough stimulus. One in every 20 people will have a single seizure at some time during their lives. However, people with epilepsy have recurring seizures.
Epilepsy is caused by abnormal electrical impulses in the brain. These pulses occur in groups of nerve cells or neurons.
These seizures can vary from person to person and for most, epilepsy will only affect them for a short period in their lives. For others however, the consequences can be more lasting. Up to 40,000 people in Ireland are estimated to have epilepsy.
What causes epilepsy?
In more than half of all cases of epilepsy, no cause can be found (this is known as idiopathic epilepsy). The person with idiopathic epilepsy is apparently healthy in every respect and there is no underlying disease or damage causing them to have seizures.
Brain injury or disease
In some cases a cause is found and there may be several reasons why epilepsy is triggered:
- Damage to the brain with or without scarring as a result of injury to the head, infection of the brain (encephalitis) or brain linings (meningitis)
- Malformation of the brain
- Degeneration of the brain
- Metabolic (biochemical) disorder as a result of low blood glucose, low calcium or drugs, particularly alcohol
- Brain tumours
- Blood clots and brain haemorrhages
How is epilepsy diagnosed?
More than likely, the GP is the first person whose advice will be sought. If there is a suspicion of epilepsy, a referral to a specialist is appropriate, usually a consultant neurologist.
The first appointment will generally consist of a discussion about symptoms. It can be useful to bring along a relative or friend who has seen you having a seizure. You will have the opportunity to explain in detail what has been happening and specifically what happened around the time of the seizure. A physical examination will also take place.
The diagnosis is usually based on what you and your relative or friend tell the doctor. There is no actual test for epilepsy. An EEG is usually carried out in hospital to help doctors identify what type of epilepsy you have. Some people may also have a CT or MRI brain scan, and these are other useful methods to help to identify the problem.
It is difficult to say how many seizures you must have before a diagnosis of epilepsy can be definitely made. In other situations diagnosis is more difficult and involves detailed history taking and brain investigations.
How is epilepsy treated?
Epilepsy is controlled with medicines prescribed by a specialist. These are known as AEDs (anti-epileptic drugs). The choice of drug depends on the type of epilepsy. The most suitable medicine is given in the smallest dose possible at first, then gradually increased until the optimum dose is reached. The dosage may be adjusted if the drug is not effective. In certain cases where symptom control is proving difficult, more than one medicine may be prescribed.
What is the outlook?
For many people with epilepsy, treatment will stop seizures. However, the outcome of the condition is dependent on the type and cause of epilepsy. Some people who develop epilepsy as a child ‘grow out’ of it and experience no long-term effects.
Many people with epilepsy lead normal lives and have no symptoms between seizures. However, practical issues such as driving restrictions that apply, may have a significant impact on the day-to-day lives of people with epilepsy.
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