What is epilepsy?

Epilepsy is a neurological condition defined as recurrent seizures. A person can have one seizure (perhaps related to illness, fever, injury, etc.) and not necessarily be diagnosed with epilepsy. Being diagnosed with epilepsy means that your brain shows seizure activity often, which leads to recurrent seizures. Seizures are the symptom of epilepsy and are caused by abnormal electrical activity in the brain. People with epilepsy can have several seizures per day, a few per month, or even reach full seizure control with adequate treatment.

 

What is a seizure?

A seizure is caused by a sudden misfiring and surge of electrical activity in the neurons in the brain. There are many different types of seizures that can cause a person to have altered movement, actions, awareness, and even emotions. Most seizures last only a few seconds to a few minutes.

 

There are two main categories of seizures:

generalized and focal

 

Generalized seizures mean that the entire brain is affected during the seizure. Types include tonic-clonic (formerly grand mal), absence (formerly petit mal), atonic, myoclonic, infantile spasms, and febrile seizures.

Focal seizures mean that only a very specific part of the brain is affected during a seizure. Types include focal with altered awareness (formerly complex partial) and focal without altered awareness (formerly simple partial).

 

 

What do seizures look like?

Seizures can look very different from person to person, but here are the common traits for each seizure type.

Tonic-Clonic: A person will likely fall to the ground and lose consciousness. Their body will begin to stiffen and then their muscles will jerk. They will likely have trouble breathing and may also bite their tongue or cheek and lose bladder or bowel control. These seizures often last 1-3 minutes and the person may take some time to fully regain consciousness afterwards.

Absence:  A person will stare blankly and have a glazed look on their face. They may also blink rapidly or flutter their eyes and have some small facial twitches and movements. These seizures last 5-10 seconds. The person is fully aware as soon as the seizure is over.

Atonic:  A person will have a sudden loss of muscle control, fall, and lose consciousness. This seizure only lasts a few seconds. The person will become fully aware shortly after the seizure is over.

Myoclonic:  A person will have sudden, short muscle jerks that involve the whole body or parts of the body (for example, just the arms or just the legs). They may jerk quickly and drop something they are holding or fall. This seizure lasts only a few seconds and the person maintains consciousness.

Infantile Spasms:  This type of seizure is a myoclonic seizure that occurs in very young children (3 and younger). The child will move suddenly like a jerking movement, let their head and arms fall forward, or lift their arms and head. These seizures are very brief. They are often confused with colic or asking to be held.

Febrile Seizures:  These are tonic-clonic seizures that occur in young children (typically 5 years and younger) only during illness or a fever and are usually shorter than a typical tonic-clonic seizure.

Focal With Altered Awareness:  A person may get up and wander around aimlessly, appear conscious but have no recollection of the seizure, appear to communicate with you but their speech is not coherent, perform automatic movements like wringing their hands or making chewing movements with their mouth, or even try to run away. These seizures are very different from person to person depending on what part of their brain is affected. These seizures typically last 1-2 minutes and is sometimes misinterpreted as drunkenness, drug use, or even mental illness.

Focal Without Altered Awareness: A person remains aware during this seizure while experiencing extreme emotional changes that they cannot explain. These changes include laughing or crying, hearing or seeing things that are not there, jerking their limbs or face, or feeling sick to their stomach. These seizures can last 1-2 minutes and may be considered an “aura” before a tonic-clonic seizure.

 

How do I help someone during a seizure?

While most epilepsy patients have seizures that will stop on their own, some seizures may become an emergency and require medical attention. Some types of seizures require little to no intervention or first aid by caretakers, while some may require some first aid or even emergency medication.

Here are some general first aid tips that you can use to help someone during a seizure:

1. Remain calm and stay with the person until the seizure ends.
2. Time the seizure. If the seizure does not end within 5 minutes, it becomes a medical emergency and you should call 911.
3. DO NOT put anything in their mouth, try to hold down the person’s tongue, or physically restrain the person. You will injure them and yourself.
4. Turn them on their side to keep their airways clear if they are having a tonic-clonic seizure.
5. Protect the person from nearby hazards. Gently and calmly guide them away from stairs or traffic, loosen any tight clothing around their neck, and protect their head from hitting the ground.
6. Help to reorient the person after they regain consciousness and provide emotional support.

 

It’s important to fully understand the different types of seizures, what they look like, and what you can do to help someone during and after that seizure. You can learn much more about seizure recognition and response here: https://www.eawcp.org/epilepsy/seizurerecognition/

 

 

What causes epilepsy?

Epilepsy can be caused by brain malformations, brain injuries, genetic conditions, birth trauma, and a few other known causes. However, 70% of epilepsy patients have ‘idiopathic epilepsy’ meaning that doctors cannot find one specific cause of the seizures.

 

How is epilepsy diagnosed?

If you think your child may be experiencing seizures, it is important to seek a professional medical evaluation. You can start with your pediatrician for an evaluation, though it’s highly likely they will refer you to a neurologist or even an epilepsy specialist called an epileptologist. Your doctor will review your child’s medical history and perform a physical. The most common test in diagnosing epilepsy is called an electroencephalogram (EEG). An EEG will show brain activity so your doctor can determine if there are signs of seizure activity.

 

How is epilepsy treated?

Epilepsy is most commonly treated by medication, which can be quite successful in controlling seizure activity. Other treatments exist and may be an appropriate match for your child, but all treatment options need to be researched and discussed with your child’s doctor first.

Every person’s seizures will be unique to them. The same type of seizure can appear very differently in two separate patients. That is why it is so important to get an accurate medical diagnosis and treatment plan. Your doctor can help you determine what a typical seizure looks like for your child, how to care for your child during a seizure, and when your child’s seizures may become a medical emergency.

 

What about seizures during school?

If your child is in school, you should also create a Seizure Action Plan with your doctor so that the school knows how to properly care for your child during and after a seizure. The Seizure Action Plan should be a part of your child’s 504 Plan or IEP. You can also have all of the school staff trained in seizure recognition and response so they are all aware of how to help your child during a seizure.

 

Epilepsy Quick Facts

Epilepsy is not contagious.

1 in 26 Americans will develop epilepsy in their lifetime.

A person of any age can develop epilepsy at any time in their life.

Epilepsy can coexist with speech and language disorders including CAS.

Having epilepsy does not mean that the person has low intelligence or a mental illness.

You cannot swallow your tongue during a seizure so you should never place an object in the mouth of someone during a seizure.

 

 

 

ADDITIONAL RESOURCES

 

Seizure Recognition and First Aid

Seizure Recognition and First Aid
By Epilepsy Association of Western and Central PA
https://www.eawcp.org/epilepsy/seizurerecognition/

Types of Seizures
By Epilepsy Foundation
https://www.epilepsy.com/learn/types-seizures

First Aid for Seizures
By Epilepsy Foundation
https://www.epilepsy.com/learn/seizure-first-aid-and-safety/first-aid-seizures-stay-safe-side

 

Epilepsy Information for Parents

Epilepsy and Parents & Caregivers
By Epilepsy Foundation
https://www.epilepsy.com/living-epilepsy/epilepsy-and/parents-and-caregivers

Epilepsy & My Child Toolkit: A Resource for Parents with a Newly Diagnosed Child
By Epilepsy Foundation
https://www.aap.org/en-us/Documents/Sharing_the_Diagnosis.pdf

Seizure Information for Parents
By Nationwide Children’s
https://www.nationwidechildrens.org/specialties/epilepsy-center/seizure-information-for-parents

 

Epilepsy and Language

Types of Language Problems in Epilepsy
By Epilepsy Foundation
https://www.epilepsy.com/article/2014/3/types-language-problems-epilepsy

Language Dysfunction in Pediatric Epilepsy
Scholarly Article
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5826845/

Epilepsy and Learning
By SickKids Staff
https://www.aboutkidshealth.ca/Article?contentid=2112&language=English

An Investigation of Chronic Epilepsy in Children: Language Profiles
Click here to view

Language Function in Epilepsy: Effects of Hemispheric Focus and Chronicity
Click here to view

 

Epilepsy and Sleep

Sleep and Epilepsy
By Epilepsy Foundation
https://www.epilepsy.com/learn/challenges-epilepsy/sleep-and-epilepsy

Lack of Sleep and Epilepsy
By Epilepsy Foundation
https://www.epilepsy.com/learn/triggers-seizures/lack-sleep-and-epilepsy

Sleep and Epilepsy: A Complex Interplay
Scholarly Article
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6139974/

Sleep and Epilepsy
By Epilepsy Society
https://www.epilepsysociety.org.uk/sleep-epilepsy#.Xn4CqYhKhPY

 

Find Epilepsy Support Near You

Epilepsy Alliance America
https://www.epilepsyallianceamerica.org/membership/current-members/

Epilepsy Foundation America
https://www.epilepsy.com/affiliates?field_affiliate_address_administrative_area=