Epilepsy is the fourth most common neurological disease and affects people of all ages; 1 in 26 people in the U.S. will develop epilepsy at some point in their lives. Those with a family history of epilepsy are at a slightly higher risk to develop this condition. Epilepsy is a spectrum condition, meaning that there are a wide range of seizure types and treatments which vary from person to person.
It is common to have some sort of warning or “aura” at the onset of a seizure (but not every patient will experience this). These sensations are sometimes difficult for patients to describe, but can include systemic disturbances (headaches, vomiting, or “butterflies” in the stomach), visual disturbances, and vertigo. The middle or “ictal” phase of a seizure corresponds to the electrical seizure activity happening in the brain. As the seizure ends, known as the postictal phase, the patient begins to recover. Some people recover immediately, while others take minutes or hours to return to feeling like their usual selves.
Categories & Symptoms
Seizures are generally described as being in one of two categories: generalized seizures and focal seizures. The difference between them is how and where they begin in the brain. Generalized seizures are indicated by specific motor and non-motor symptoms. These motor symptoms may include sustained rhythmical jerking movements, muscles becoming weak or limp, muscles becoming tense or rigid, brief muscle twitching, or epileptic spasms (the body flexes and extends repeatedly). The non-motor symptoms may include staring spells or twitching of the eyelids or another specific body part. Focal seizures may include some of the motor symptoms common to generalized seizures, and also automatisms (repeated automatic movements) like clapping or rubbing of hands, lip-smacking or chewing, or running. The non-motor symptoms of a focal seizure could appear as changes in sensation, emotions, thinking or cognition, autonomic functions (such as gastrointestinal sensations, waves of heat or cold, goosebumps, heart racing, etc.), or lack of movement known as behavior arrest.
Diagnosis & Treatment
Patients can have a difficult time describing their own seizure type, so initial diagnosis is usually based on the descriptions of observers. Having tests like an MRI (magnetic resonance imaging) scan to look at the brain and EEG (electroencephalogram) tests to record the electrical activity of the brain are commonly prescribed to diagnose types of seizures and epilepsy properly.
If you suspect – or have been told – you have experienced a seizure, seek medical attention. Your physician will likely refer you to a neurologist. Seeing a neurologist who treats epilepsy and seizure disorders can help you explore treatment options including medication, surgery, devices, lifestyle, dietary therapy, or a clinical trial. Your doctor can also support you by connecting you to local epilepsy support groups with whom you can share your feelings and receive compassion and education.