1. What is epilepsy?
Epilepsy is a chronic (long-lasting) medical condition marked by
recurrent epileptic seizures. An epileptic seizure is an event of
altered brain function caused by abnormal or excessive electrical
discharges from brain cells. Epilepsy is one of the most common
neurologic disorders, affecting up to 1 percent of the population
in the United States.
There are different types of seizures, different types of
epilepsy syndromes, and different causes of epilepsy. For example,
both brain tumors and stroke can cause seizures and lead to chronic
epilepsy. Some of the causes can be diagnosed and treated with
medicines, and some require surgery.
2. What are some of the causes of epilepsy?
About 65 percent of newly diagnosed epilepsy cases have no obvious
cause. Of the remaining 35 percent, the more common reasons include
stroke, congenital abnormalities (those we are born with), brain
tumors, trauma, and infection. It is important to determine the
cause to help guide treatment.
3. Who treats epilepsy?
A neurologist, a doctor who specializes in diseases of the brain
and nervous system, best determines the diagnosis of epilepsy. Some
neurologists take advanced training and become epileptologists.
These doctors specialize in the diagnosis and treatment of
epilepsy. This involves determining the cause of the epilepsy and
starting anti-convulsant medicine to prevent further seizures. Many
internists and family practice doctors also treat epilepsy.
4. How is epilepsy diagnosed?
The evaluation of patients with epilepsy is aimed at determining
the type of seizures (epileptic versus non-epileptic) and their
cause, since various seizure types respond best to specific
treatments. The diagnosis is based on:
- The patient's medical history, including any family history of
seizures, associated medical conditions, and current medicines. The
doctor will ask you some important questions, including the
following:
-- At what age did the seizures begin?
-- What circumstances surrounded your first seizure?
-- What factors seem to bring on the seizures?
-- What do you feel before, during, and after the seizures?
-- How long do the seizures last?
-- Have you been treated for epilepsy before?
-- What medicines were prescribed and in what dosages?
-- Was the treatment effective? - Others who have often seen you before, during, and after
seizures, such as family and close friends, should be present to
provide details of your seizures if they involve loss of
consciousness.
- A complete physical and neurological exam of muscle strength,
reflexes, eyesight, hearing, and ability to detect various
sensations is used so that your doctors can better understand the
cause of your seizures. Additional testing often includes:
-- An electroencephalogram (EEG), which measures electrical
activity in the brain
-- Imaging studies of the brain, such as magnetic resonance imaging
(MRI)
-- Blood tests to measure red and white blood cell counts, blood
sugar, blood electrolyte levels, and to evaluate liver and kidney
function (Blood tests help rule out other illnesses.)
-- Other tests are used as needed, including magnetic resonance
spectroscopy (MRS), positron emission tomography (PET), and single
photon emission computed tomography (SPECT).