What is Epilepsy?

Epilepsy is a neurological condition that affects over 600,000 people in the UK, almost 1 in every 100 people. It causes sufferers to have recurring seizures. Some people with epilepsy may stop having seizures over a period of time, however most epileptics will have the condition for life. Epilepsy can start at any age but most often begins during childhood.

During normally brain activity electrical signals are sent to the brain via neurons. An epileptic seizure happens when the neuron cells in the brain have an abnormal surge in electrical activity. There are over 40 types of epilepsy and seizures can vary in severity and symptoms. Some people will be lucid and aware that they are having a seizure whilst others may lose consciousness. Some epileptics will experience unusual feelings and numbness in their limbs whilst others will collapse to the ground and their limbs will be rapidly convulsing or jerking. There are two main types of seizure, these are focal seizures (also known as partial seizures) and generalised seizures. Focal seizures start in one section of the brain and the symptoms vary depending on the part of the brain effected. Generalised seizures affect both sides of the brain and the patient may lose consciousness. These seizures can come without any obvious warning. After the seizure the sufferer may not recall what happened during the seizure.

The causes of Epilepsy

While the causes of epilepsy are still not completely understood, there is some evidence to suggest that epilepsy can be inherited (also known as Idiopathic epilepsy) but researchers are still not sure how this is passed down genetically. Epilepsy can also be caused by a trigger event, this is referred to as symptomatic epilepsy. Trigger events can include a traumatic brain injury, low oxygen levels at birth causing a defect in the brain and brain infection such as meningitis or a stroke. However, for over half the people diagnosed with epilepsy the cause is unknown. 

How to treat Epilepsy

Epilepsy can't currently be cured, however the symptoms can often be controlled or reduced with drugs called AEDs. Unfortunately Anti-Epilepsy Drugs are not always successful and 30% of sufferers are unable to control their seizures with medication. In this cases surgery can be required. There are two types of surgery available for epileptics: neurosurgery and vegus nerve stimulation. A ketogenic diet can along be helpful in reducing symptoms. This is particularly successful with children. Regular exercise, quality sleep and reduced alcohol intake can also help to reduce seizures. Regular reviews with a neurologist are also recommended to help monitor and control epileptic seizures.

What triggers an epileptic seizure?

The triggers vary for different people, so if you have seizures it is a good idea to make a note of anything you think could be the cause. This can help you to recognise any patterns of behaving leading to seizures and may help you to identify your triggers.

Epilepsy Diagnosis

A one off seizure would not necessarily be regarded as epilepsy, as these can happen to anyone as an infrequent occurrence. Epilepsy is only diagnosed with reoccurring seizures. If you think you may have epilepsy it is recommended that you keep a record of what was happening before each seizure and anything that you think could be a trigger. It can also be helpful to talk to those who were around you during your seizures as they can confirm your behaviour during the seizure (such as limb jerking or stiffness, being withdrawn or losing consciousness).

Having this log will help your GP to diagnose which type of epilepsy you have and work out the best method (or combination of methods) to control your seizures. Your doctor may require further tests for diagnosis such as an electroencephalogram (EEG) or magnetic resonance imaging (MRI) scan. An EEG uses electrodes placed on your scalp to monitor and identify unusual brain activity. The neurologist may ask you to complete different activities during the test such as deep breathing, closing your eyes or looking at flashing lights. Testing will be stopped if at any point it looks like this is triggering a seizure.

You may also be given a portable device to test while you are sleeping or during the daytime. An MRI can help by giving details images of your brain, this can help to identify any physical abnormalities that may be causing your epilepsy.

What to do if you think someone is having an epileptic seizure:

If the patient is having a generalized seizure (unconscious and falling to the ground followed be jerking. Their lips may have a blue tinge) the following procedure is recommended:

• Move any nearby dangerous objects.
• Cushion their head.
• Loosen any tight clothing that may be affecting their breathing.
• Look for a bracelet or card to indicate the patient has been diagnosed as epileptic.
• Carefully place the patient in the recovery position after the seizure has finished. This should open their airway and help them to breath.
• Stay with the patient until they have recovered and talk to them to keep them calm.

It is recommended that you avoid the the following:

• Don't try and hold the person still or refrain movement.
• Don't try to move them unless they are in danger.
• Don't attempt to wake them.
• Don't give them any food or drink until they are fully recovered.

If the patient is having a partial seizure (they may be confused, wandering around, pulling at their clothing, plucking their lips) it is recommended that you:

• Guide them from danger.
• Loosen any tight clothing that may be affecting their breathing.
• Keep calm and reassure them.
• Stay with them until they are fully recovered.

It is recommended that you don't do any of the following:

• Don't restrain the patient.
• Don't act in a way that could frighten or shock them.
• Don't assume they are conscious of their surroundings.
• Don't give them any food or drink till they are fully recovered.
• Don't attempt to bring them to consciousness.

When you should call the ambulance:

It is not always necessary to call the ambulance if someone has a seizure. You should call for an ambulance in the following situations:

• You think it may be the first time they have had a seizure.
• The seizure lasts longer than 5 minutes.
• The patient does not regain consciousness.
• If a series of seizures occur or if the patient goes straight from one seizure into another.