Epilepsy
Also called: Seizure disorder
A tendency to have recurrent unprovoked seizures — bursts of abnormal electrical activity in the brain. Seizures range from brief absences to convulsions.
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About 50 million people worldwide.
Causes
- Genetic epilepsies
- Brain injury, stroke, tumours
- Infections (meningitis, encephalitis, neurocysticercosis)
- Developmental brain malformations
- Often no cause found
Risk factors
- Family history
- Head injury
- Stroke
- Dementia
- Complications at birth
Symptoms
- Convulsions with loss of consciousness (tonic–clonic)
- Staring spells (absence)
- Jerks (myoclonic)
- Focal seizures: strange sensations, déjà vu, automatic movements
- Confusion and tiredness afterwards
Diagnosis — tests and examinations
- Eyewitness account and video
- EEG
- MRI brain
- Blood tests and ECG to exclude mimics
Treatment
Medicines and medical treatment
- Antiseizure medicines: levetiracetam, lamotrigine, sodium valproate (avoided in women who may become pregnant), carbamazepine and others
- Rescue benzodiazepines (buccal midazolam) for prolonged seizures
Operations and procedures
- Epilepsy surgery (e.g. temporal lobectomy) for drug-resistant focal epilepsy
- Vagus nerve stimulation
- Ketogenic diet in selected children
Self-care, home remedies and lifestyle
- Take medicines regularly
- Get enough sleep; limit alcohol
- Follow driving laws
- Shower rather than bathe; do not swim alone
Possible complications
- Status epilepticus (emergency)
- Injuries
- Sudden unexpected death in epilepsy (SUDEP)
- Depression
Prevention
- Head protection, stroke prevention, safe pregnancy care
Outlook
About 70% become seizure-free with medication.
When to see a doctor
Call emergency services if a seizure lasts over 5 minutes, seizures repeat without recovery, or a first seizure occurs.
Sources and further reading
These sources cover this condition. They have not been checked against every statement on this page.
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