7 Frequently Asked Questions About Seizures and Epilepsy from a Neurologist

Epilepsy is the fourth most common neurological disorder in the world, but even though it is not rare, it can still be overwhelming and frightening for patients and their families. Here are seven frequently asked questions about seizures and epilepsy.

1. What is a seizure?
   A seizure is an abnormal electrical activity in the brain that can affect how you appear and act. These bursts of electricity in the brain can cause involuntary changes in movement, behavior and function. Not everyone who has a seizure will have epilepsy. A seizure can be a one-off event or a symptom of other medical issues.
   
   
2. What is epilepsy?
   Epilepsy is a neurological condition where a person has repeated seizures. A diagnosis of epilepsy is made after a patient has two or more unprovoked seizures, but also can be diagnosed when a patient has had a single unprovoked seizure and high risk for recurrent seizures, such as having an abnormal electroencephalogram (EEG) or abnormal MRI brain.
   
   Epilepsy is a spectrum disorder, meaning there are many different types of seizures with different levels of severity.
   
   
3. What is an unprovoked seizure?
   An unprovoked seizure is a seizure with no obvious cause or trigger. Provoking factors can be things such as a significant electrolyte abnormality, alcohol or drug withdrawal, significantly abnormal blood sugar, head injury or brain trauma, fever or even a reaction to prescribed or over-the-counter medication.
   
4. What are the symptoms of seizures?
   The symptoms of seizures will vary depending on the type of seizure the brain has. There are two main types of seizures: generalized seizures and focal seizures.
   
   Generalized seizures are caused by abnormal electrical discharges that occur in all the regions of the brain at the same time. This can manifest as a full-body convulsion, called generalized tonic-clonic seizure, or can be more subtle such as a brief staring seizure, known as an absence seizure. Generalized seizures typically last between one to three minutes, but tonic-clonic seizures can last up to five minutes and may require emergency medical attention.
   
   A focal seizure can have various symptoms based on where in the brain the seizure is coming from. These seizures can sometimes start with a warning, called an aura, and can include symptoms like muscle contractions, unusual head or eye movements, inability to speak or respond, or numbness or tingling skin. Some people also report a loss of awareness during a focal seizure, but others remain fully aware during a focal seizure.
   
5. How does your doctor diagnose epilepsy?
   To diagnose epilepsy, your doctor will listen to the symptoms of your seizures and your medical history to better understand your condition. Your evaluation may also include imaging of the brain (through MRI or CT) and an electroencephalogram (EEG) is often required.
   
   An EEG is the most common test to diagnose epilepsy and consists of attaching electrodes to your scalp with a paste or a cap. The electrodes record your brain activity and can show changes in your pattern of brain waves, even when you’re not experiencing a seizure.
   
6. How is epilepsy treated?
   There are multiple anti-seizure medications that can be used to treat epilepsy and most patients can obtain seizure-freedom with medication. There are some cases where medication alone may not be enough to prevent seizures, in which case your physician may discuss surgery, dietary therapy or implantable devices to control seizures.
   
7. What can be done to prevent seizures?
   Outside of medication, there are a few things that can be done to make seizures less likely to occur, including:
   
   - Getting adequate sleep (7 or more hours per night for adults, 9 -12 hours per night for children)
   
   - Avoiding known triggers, like flashing lights
   
   - Avoiding medications that can provoke seizures, such as diphenhydramine and tramadol.
   

If you or a loved one are experiencing seizure events, you should contact your doctor.