epilepsy

 What is epilepsy?

Epilepsy is the tendency to have repeated seizures that begin in the brain.

Our brains

The brain is a complex structure made up of millions of nerve cells called neurones. It controls a wide range of tasks such as consciousness, awareness, movement, and posture. The brain sends and receives messages to make these tasks happen. If there is a mistake sending or receiving messages, a brief break in some or all of the brain's tasks can happen. If this happens a person may have a seizure.

Seizures

Seizures can happen for many different reasons. A person with diabetes may have a diabetic seizure if their blood sugar level is too high. A person with epilepsy has an epileptic seizure if their usual brain activity is suddenly disturbed.

Some people call their seizures by a different name – such as a fit, funny turn, attack or blackout.

What is epilepsy?

Epilepsy is a physical condition that starts in the brain - a neurological condition. It is a symptom that the way a person's brain works is sometimes disrupted. When this happens, a person may suddenly have a seizure. Many people will have a single seizure at some time in their lives, but this does not mean that they have epilepsy. If a person has epilepsy it means they have had more than one seizure that began in the brain.

How many people have epilepsy?

Epilepsy is the most common serious neurological condition in the UK. 1 in every 130 adults and children in the UK has epilepsy. This means that there are around 450,000 people with epilepsy in the UK.

What causes epilepsy?

Anyone can develop epilepsy; it occurs in all ages, races and social classes. The reasons why some people develop epilepsy are not straightforward and there are many possible causes. Whatever the reason, a person's seizure threshold will play a key role.

Seizure threshold

A person's seizure threshold is their individual level of resistance to seizures. Everyone has a seizure threshold and anyone can have a seizure if the circumstances are right.

The seizure threshold is part of everyone's genetic make up - how we each inherit our characteristics - which is passed from parent to child.

The chance of a person developing epilepsy depends on the seizure threshold of both their

parents. If a person has a low seizure threshold they are more likely to start having seizures suddenly for no obvious reason. However, an outside factor could also cause a person with a low seizure threshold to start having seizures. But because of the low seizure threshold the event could be quite mild and still result in a person having seizures.

If a person has a high seizure threshold they are less likely to start having seizures suddenly. Their seizures are more likely to begin as a result of an outside factor, for example after a severe head injury.

Possible causes

The causes of epilepsy can be put into three different groups. Each group includes a number of different types of seizure.

Symptomatic epilepsy

When there is a known cause for a person's epilepsy starting it is called symptomatic epilepsy. The reasons can include head injury, infections of the brain such as meningitis, a stroke, or because of a scar on the brain. Images from scans of the brain may show what the cause is. The response to drug treatment can vary from person to person.

Idiopathic epilepsy

In this type of epilepsy, there is no clear cause for the seizures suddenly starting. It is thought having a low seizure threshold could be the reason. The person usually has no other disabilities. The response to epilepsy drug treatment is usually good.

Cryptogenic epilepsy

When it is not clear if epilepsy is symptomatic or idiopathic a person may be told that they have cryptogenic epilepsy. Unlike idiopathic epilepsy, it is not thought to have started because of a low seizure threshold. It's suspected that there is a physical reason that has yet to be found.

How is a diagnosis made?

Because there is no obvious sign a person has epilepsy, unless they are having a seizure, this can make diagnosing epilepsy difficult. A diagnosis is usually made after a person has had more than one epileptic seizure. When a person has had a seizure they may not remember what happened. This means it can be helpful to have information from someone who saw the seizure happening.

A number of investigations, including blood tests, an electroencephalogram (EEG) and scans such as computerized tomography (CT) or magnetic resonance imaging (MRI) may provide additional information. However, these tests cannot confirm or rule out a diagnosis of epilepsy.

Are there different types of epilepsy?

Epilepsy may take many forms and just knowing that a person ‘has epilepsy' gives very little useful information about that individual and the type of epilepsy and seizures they have.
Information on epileptic seizures.

How might epilepsy affect my life?

If a person's epilepsy is controlled then epilepsy may not stop them from leading a full life. However, having seizures for the first time or being told that the diagnosis is ‘epilepsy' can affect people in different ways.

Often people know very little about epilepsy or they may have misunderstandings about it, which might make it hard to come to terms with. Talking about worries, asking questions and getting information about epilepsy may help deal with any concerns a person with epilepsy or their family and friends might have.

If the person continues to have seizures, then this may affect some parts of their daily living. In this situation, taking practical steps to reduce possible risks can help to minimise any problems. It can be helpful to emphasise a person's abilities rather than focusing on any negative impacts of their epilepsy.

Many people are able to keep their seizures to a minimum by avoiding situations that they know may bring on a seizure, sometimes called triggers.

These triggers may include lack of sleep, too much alcohol, emotional upsets or missing medication. Taking care of a person's overall wellbeing is a vital part of the complete management of their epilepsy.