Epilepsy

Despite what you may think, epilepsy seizures don’t always occur as jerky movements or convulsions. Seizures can vary depending on the person and type of epilepsy. Learn more about epilepsy and how to help if you see someone having a seizure.

What is epilepsy?

Epilepsy isn’t a disease but rather a neurological disorder that disrupts normal brain activity. For a few seconds or minutes, brain cells send confused signals (abnormal and involuntary electrical discharges) to the cells of the body. The body then responds in various ways: convulsions, brief periods of staring, muscle spasms, altered consciousness, or strange behaviour or sensations.

Some forms of epilepsy have a hereditary component. Scientists haven’t yet identified all of the genes responsible for the disorder, but they have made a lot of progress in recent years through research.

Who can get epilepsy?

This neurological disorder affects 300,000 Canadians, including 120,000 Quebeckers. Each year, over 15,000 Canadians are diagnosed with epilepsy. More than half of all new cases are found in children under the age of 10 and seniors over the age of 60. About 80% of people with epilepsy have their first seizure before they turn 18.

Prejudice hurts

For people with epilepsy, misconceptions and prejudices can be just as painful as the disorder itself. Many famous people from history who had epilepsy—such as Beethoven, Van Gogh, and Agatha Christie—used their talents despite their condition. Epilepsy does not affect intelligence. When people with epilepsy follow their medical treatment to the letter, they can live normal lives—and even make history.

Types of seizures

Epilepsy seizures are classified in two major categories: partial and generalized seizures.

Partial seizures

Partial seizures (also called focal seizures) affect a restricted or “focal” area of the brain. These seizures are subdivided into simple partial seizures and complex partial seizures, depending on the symptoms.

Generalized seizures

Generalized seizures occur when abnormal neurological activity affects the entire brain. These seizures  include absence seizures (formerly called “petit mal seizures”), tonic-clonic seizures (formerly called “grand mal seizures”), and myoclonic, tonic, clonic, or atonic seizures.

A neurologist can determine the type of seizure a person has had after taking:

• a detailed medical history
•  a complete physical
• blood and other bodily fluid tests
• an electroencephalogram (EEG)
• magnetic resonance imaging

In more than half of people, the cause of epilepsy is unknown. However, some health problems suspected as possible causes of epilepsy include stroke, head trauma and some cancers.

What triggers seizures?

External factors can trigger a seizure:

• stress
• strong emotions, such as anger, anxiety and fear
• a lack of sleep
• flashing lights or strobe lights
• heavy drinking
• an unhealthy diet or irregular meals
• heat or humidity
• illness, fever or allergies
• certain medications
• taking medication irregularly

Your doctor will most often treat the external factor triggering a seizure (e.g., a high fever or a severe infection) and not the epilepsy itself.

Epilepsy symptoms

Seizure symptoms can vary depending on the person and the type of epilepsy. Here are some possible signs and symptoms:

• fainting, loss of consciousness
• muscle spasms in the arms and legs or the whole body
• loss of muscle tone or stiffening of the body
• olfactory hallucinations or vision problems
• empty gaze, confusion
• memory lapses
• rapid and continued blinking

Epilepsy treatment

Drugs don’t cure epilepsy, but they can control its symptoms. These drugs are called “anticonvulsants” or “antiepileptic drugs.” The best medication will be chosen for your seizure type and your personal characteristics. Almost half of patients no longer have seizures after starting a single medication. Other patients need a combination of medications to limit the frequency and intensity of their seizures.

Some people may not receive any medication after a first seizure if they aren’t likely to have another, as these drugs have side effects. But patients and their doctors must make this decision based on several factors, such as the risk of another seizure.

Some people will need to take epilepsy medication for their entire lives. Other people who haven’t had a seizure in a few years can try to progressively stop their medication with their doctor’s permission. This decision is a personal one and will depend on the type of seizure, what triggers the seizures, and what you feel is best for you. Don’t stop taking your medication without first talking to a health care professional. Stopping suddenly could trigger new seizures. Your pharmacist is your medication expert, so don’t hesitate to ask about your medication.

If you have epilepsy and are taking medication for it, always talk to your doctor or pharmacist before taking another prescription or over-the-counter medication. Combining certain drugs could make your treatment less effective and could even be toxic.

People who see no improvement despite trying a number of drugs may consider surgery. However, surgery is not a good option for every type of epilepsy and has risks.

How to help someone who is having a seizure

If you see someone having an epilepsy seizure with muscle spasms:

• Stay calm.
• Give the person space and remove any objects that could cause an injury.
• Remove any ties, scarves or tight objects around the person's neck.
• Do not put anything in the person’s mouth. Despite what you may have heard, people having a seizure are unlikely to swallow their tongues.
• Don’t try to hold the person or keep them from moving.
• Put a soft object under their head and turn them gently on their side.
• Call 9-1-1 if the seizure lasts for more than five minutes, or if it starts again once the person has regained consciousness.
• Let the person rest, and speak in a soothing tone.

Pregnant women, people with diabetes, and people who become injured during a seizure must go to the hospital no matter how long their seizure lasted.

If you have epilepsy, it is strongly advised that you wear a medical ID bracelet with your condition. This will alert first responders to the nature of the seizure.

Caution and precautions

In general, people with epilepsy who get good care can lead a normal life, although with some restrictions, as you may not be able to drive. 

Driving with epilepsy

You’re not allowed to drive a vehicle if your condition is not controlled or if your first seizure was recent. How long you'll have to go without driving will vary depending on a number of factors, like the type of seizure. Check with your doctor or the Société de l’assurance automobile du Québec (SAAQ) for more information.

Here are some recommendations to avoid a seizure while driving:

• Avoid driving when tired.
• Don’t drive for long periods without eating or sleeping.
• If your drug regimen is changed or stopped, this could compromise your ability to drive. It would be better not to drive at all for a while to see how the change affects you.
• Take your medication regularly.
• The consequences of having a seizure when driving can be more disastrous than those from a severe seizure. Any seizure attack when driving must be reported to your doctor. You must also stop driving until you talk to your doctor.
• Avoid drinking alcohol before driving. Alcohol always impairs the ability to drive and could cause an epilepsy seizure you might otherwise not have had.

Pregnancy and breastfeeding

Women with epilepsy can have healthy pregnancies, but some epilepsy drugs can increase the risk of birth defects such as cleft lip, heart problems or neural tube defects. But know that more than 90% of babies born to mothers with epilepsy are healthy. Your doctor will have to closely monitor you throughout your pregnancy. Before conceiving, talk to your doctor, who can change your drug regimen to reduce the risks to your baby. Also, never stop taking your medication without talking to a health professional first, as seizures could also put your baby at risk. Epilepsy seizures during pregnancy are potentially more harmful than the risks of medication.

Breastfeeding is possible but will depend on the drug that you’re taking. Ask your pharmacist or doctor if you can continue your medication while breastfeeding.

 

If you have epilepsy, you need to adopt a healthy lifestyle and avoid triggers to reduce the frequency and intensity of your seizures. Follow your medical treatment to the letter. This is essential to control your seizures and live a normal life. Your pharmacist is always here to help and answer your questions.

Source:
Association québécoise de l’épilepsie (French)