When should I see my doctor?
Always see a doctor if:
- this is your first seizure
- you have repeated seizures
- you have seizures more often than normal
- you’re not sure if you’ve had a seizure
You should seek medical attention after a seizure if you are injured or if you are pregnant or have diabetes.
HOW IS EPILEPSY DIAGNOSED?
Electroencephalogram (EEG) is the most common test used in diagnosing epilepsy. First, electrodes are attached to your scalp with a paste. It’s a non-invasive, painless test. You may be asked to perform a specific task. In some cases, the test is performed during sleep. The electrodes will record the electrical activity of your brain. Whether you’re having a seizure or not, changes in normal brain wave patterns are common in epilepsy.
Imaging tests can reveal tumours and other abnormalities that can cause seizures. These tests might include:
- CT scan
- Position emission tomography (PET)
- Single-photon emission computerised tomography
Did you know?
1 in 3 people with epilepsy have a family member with it.
HOW IS EPILEPSY TREATED?
Treatment with medications or sometime surgery can help most people with epilepsy have fewer seizures, or stop having seizures completely. In some cases, surgery can also reduce or eliminate seizures when drugs are ineffective.
The most commonly used treatment for epilepsy are Anti-Epileptic-Drugs (AEDs). AEDs help control seizures in around 7 out of 10 people, according to the WHO. They work by changing the levels of chemicals in your brain.
There are many types of AEDs and the one prescribed for you will depend on your age as well as the type and frequency of seizures you have. It can take some trial and error to find the best drug and dosage with the fewest side effects for you. AEDs do not cure epilepsy, but can stop seizures happening. Around half of all people with epilepsy may be able to stop taking medications after two years without a seizure.
The most common surgery is a resection. This involves removing the area of the brain causing the seizures. Most often, the temporal lobe is removed in a procedure known as temporal lobectomy. In some cases, this can stop seizures completely.
Vagus Nerve Stimulation Therapy
Vagus Nerve Stimulation Therapy (VNS Therapy) is where a small electrical device similar to a pacemaker is surgically placed under the skin of your chest and electrically stimulates the nerve that runs through your neck. This can help prevent seizures. Implanting a vagus nerve stimulator is generally only considered if antiepileptic drugs are not controlling the seizures satisfactorily.
Deep Brain Stimulation (DBS)
Deep Brain Stimulation (DBS) is similar to VNS, but the device placed in the chest is connected to wires that run directly into the brain. Bursts of electricity sent along these wires can help prevent seizures by changing the electrical signals in the brain. DBS is a fairly new procedure that's not used very often, so it's not yet clear how effective it is for epilepsy.
The Ketogenic Diet is a strict, medically supervised diet that may be a treatment option for some with epilepsy. More than half of people who don’t respond to medication benefit from this special high fat, low carbohydrate and protein diet.
7 facts about epilepsy and seizures
- Epilepsy is a spectrum condition with a wide range of seizure types varying from person-to-person.
- Most seizures happen suddenly without warning, last a short time (a few seconds or minutes) and stop by themselves.
- There are over 40 different types of seizure and people may have one or several different seizure types.
- What seizures look like can vary.
- Not all seizures involve convulsions. Some people seem vacant, wander around or are confused during a seizure.
- Around 3% of people with epilepsy are photosensitive, which means their seizures are brought on by flashing lights.
- In general, seizures are well controlled by treatment in about 4 in 5 cases.
COMPLICATIONS OF EPILEPSY
Having epilepsy puts you at greater risk of injury.
During a seizure you might fall, knock yourself, or breathe in food or saliva. You should avoid jobs using heavy machinery, working at heights or under water. You may also be stopped from driving unless your seizures are controlled. Precautions may be required around water, such as when swimming or bathing.
A rare but serious complication of epilepsy is SUDEP, or sudden unexpected death in epilepsy. SUDEP refers to deaths in people with epilepsy that are not caused by injury, drowning, or other known causes. Most, but not all, cases of SUDEP occur during or immediately after a seizure. While the exact causes of SUDEP aren’t fully understood, it’s thought that sudden heart or breathing problems may contribute. The risk for SUDEP is higher if your epilepsy isn’t treated.
Things that can help reduce risks of SUDEP include:
- Taking your AEDs as prescribed
- Avoiding sudden changes to your AEDs
- Having good seizure control especially at night, and using a seizure alarm if you have seizures at night
- Having regular reviews with your doctor or specialist to monitor your epilepsy and your general health.