Epilepsy and seizures: An expert guide

Epilepsy is a neurological disorder characterised by recurrent seizures that can significantly impact daily life, leading to challenges in managing symptoms and maintaining a sense of normalcy. Dr Saifuddin Shaik, renowned consultant neurologist, provides an expert insight.

What is epilepsy?

Epilepsy is a chronic neurological disorder defined by repeated, unprovoked seizures. Seizures occur when there is a sudden surge of electrical activity in the brain, disrupting normal communication between brain cells. These episodes can vary in severity and manifestation, ranging from brief lapses in attention to intense convulsions.

In some cases, the condition is linked to genetic factors, with certain types of epilepsy running in families. Other possible causes include brain injury and brain tumours. In many cases, however, the cause of epilepsy cannot be identified.

Are there different types of seizures?

Yes, seizures are categorized into two primary types: focal (or partial) seizures and generalised seizures.

Focal seizures

Focal seizures arise from one specific area of the brain. There are two types:

• Focal aware seizures: You remain conscious during the seizure and may experience unusual sensations, such as tingling, a strange taste, or visual disturbances.
• Focal impaired awareness seizures: These seizures involve a change or loss of consciousness. You may appear confused or dazed and may not remember the event.

Generalised seizures

Generalised seizures affect both sides of the brain and usually result in a loss of consciousness. There are different types, including:

• Absence seizures: Often referred to as "petit mal" seizures, these are brief episodes where you may stare blankly into space and appear unresponsive.
• Tonic-clonic seizures: Also referred to as "grand mal" seizures, these involve a combination of muscle rigidity (tonic phase) and rhythmic jerking movements (clonic phase). These seizures are often what people think of when they hear the term "seizure."

How is epilepsy diagnosed?

The first step in diagnosing epilepsy is taking a detailed medical history. A specialist such as a neurologist will ask about your symptoms, the frequency and duration of your seizures, and any potential triggers. Equally, it’s also important to discuss any family history of seizures or neurological disorders.

A neurological examination will then assess your motor abilities, sensory perception, and reflexes. This will help the neurologist identify any neurological abnormalities that could be related to epilepsy.

An electroencephalogram (EEG) is a crucial diagnostic tool for epilepsy that records the electrical activity of the brain and can detect abnormal patterns that may indicate a predisposition to seizures. During an EEG, small electrodes will be placed on your scalp to monitor brain activity. The test is non-invasive and painless.

In some cases, imaging tests such as MRIs or CT scans may be ordered. These tests provide detailed images of the brain, helping to identify any structural abnormalities, such as tumours or scar tissue, that could be causing seizures.

What treatments are available for epilepsy?

The primary treatment for epilepsy involves the use of anti-epileptic drugs (AEDs). These medications help prevent seizures by reducing abnormal electrical activity in the brain. Commonly prescribed AEDs include Valproate and Levetiracetam.

It's important for you to take your anti-epileptic medication exactly as prescribed to maintain seizure control. While AEDs can be highly effective, they may also have side effects, such as dizziness, fatigue, and mood changes. Regular follow-up appointments with your neurologist are essential to monitor the effectiveness of the medication and make any necessary adjustments.

For some patients, especially with focal epilepsy that doesn’t respond well to medication, epilepsy surgery may be an option. This involves removing the part of the brain where seizures begin.

How else can I help control my seizures?

In addition to medical treatments, identifying and avoiding seizure triggers is crucial for managing epilepsy. Common triggers include stress, lack of sleep, alcohol and drug use, and flashing lights.

Likewise, engaging in regular physical exercise can help reduce stress and improve overall health, which may, in turn, help control seizures. It’s important, however, to choose safe activities and avoid those that could pose a risk during a seizure.

If you would like to book an appointment with Dr Shaik, head on over to his Top Doctors profile today.