Facts

• Over three percent of the Canadian population is affected by epilepsy (Epilepsy Canada).
• Every day in Canada, 42 people learn that they have epilepsy (Epilepsy Canada).
• Epilepsy is a disorder, not a disease (it isn’t contagious).
• In many cases of childhood epilepsy, the disorder can disappear completely.
• Famous people with epilepsy include writer Charles Dickens, actor Danny Glover, composer Peter Tchaikovsky, artist Vincent van Gogh and philosopher Socrates.

Causes

The causes of epilepsy quite often remain unknown, but there are many common conditions that may cause the onset of seizures. They include:

• Brain injuries
• Infections
• Genetics: if another family member had epilepsy, you may be predisposed
• Metabolic abnormalities
• Tumours and brain lesions

Symptoms

There are four main types of epileptic seizures:

Simple Partial Seizures: These are the least severe seizures during which people do not lose consciousness. They are characterized by strange and unusual sensations. The person is usually aware of what is happening and the seizures do not go on for long periods of time. Symptoms of this type of seizure can include sudden movement, a hearing or vision disruption, stomach discomfort or a sudden sense of fear.

Complex Partial Seizures: Usually involves a loss of motor awareness. The person may appear dazed and confused and perform various actions such as random walking, mumbling, head turning or pulling of clothing. In many cases, the person cannot remember what happened.

Petit-Mal Seizures (otherwise known as Generalized Absence Seizures): Characterized by minimal or no body movements except for eye blinking, where the person has a sudden loss of conscious activity. This type of seizure happens without warning and is seen most often in young children who typically outgrow the disease during puberty.

Grand Mal Seizures (otherwise known as Tonic Clonic Seizures): Known as the worst seizure, they usually affect the body to the point where it becomes rigid and stiff followed by violent muscle contractions. There is a loss of consciousness followed by confusion and disorientation.

Diagnosis

There are several steps in diagnosing epilepsy. When someone who has had a seizure seeks medical help, the doctor will want to resolve the following issues:

• Was the seizure caused by a short term problem (like fever or infection) that can be corrected?
• Was it caused by a continuing problem in the brain?
• Is there anything about the structure of the brain that could cause seizures?
• Was the seizure an isolated event, or does it mean that the person has epilepsy?

Your doctor will try to find the answers to these questions through:

• A detailed medical history.
• A thorough physical examination, especially of the nervous system.
• Analysis of blood and other body fluids.
• Electroencephalographic (EEG) recordings.
• Magnetic resonance imaging (MRI) and/or computerized tomography (CT) scans.

Treatment

There are several different ways to go about treating epilepsy, the most popular one being anti-epileptic drugs. Below are the main treatment methods for epilepsy:

Drugs:

• There are many different drugs to treat epilepsy. Some have been around for years while others are very new. The drug used depends on the type of epilepsy that the individual has.
• Some of the more popular drugs for epilepsy include: Dilatin, Topamax, Tegretol, Valium, Sabril, Lamictal and Frisium.
• The upside of using drugs to control epilepsy is that if you find the right drug and the right dosage, you can go seizure-free for days, weeks, months or even years.
• The downside of using these drugs is that most have significant side effects that can include an increase in body hair, depression, anxiety and weight gain. Side effects depend upon the drug and dosage you are taking.

Surgery:

• Usually only performed on patients who have tried many medications to no avail.
• The risks and benefits for each patient must be very carefully discussed and weighed.
• Having the surgery does not guarantee that the patients will be seizure-free or that they won’t need to take medication anymore.
• The upside of surgery is that depending where the root of the epilepsy is in the brain (which can easily be discovered using testing), brain surgery can be completed successfully and the patient can be seizure-free.
• The downside of surgery is that going into the brain and removing tissue carries large risks including memory problems, speech problems, mobility impairment or even death.

Ketogenic Diet:

• The ketogenic diet is strictly controlled and used mainly in young children with untreatable epilepsy.
• The diet is very high in fat content and low in carbohydrates and proteins. It works by tricking the body into burning fats instead of carbohydrates. This process releases ketones into the body, putting it into a state of ketosis (when the body begins to burn a large amount of fat in response to insufficient levels of glucose in the body). This diet has been shown to be useful in controlling seizures.
• This diet is usually only followed very rigidly during childhood between the ages of one and eight.

Vagus Nerve Stimulation:

• Used only when medication has failed to control seizures, vagus nerve stimulation is where a flat, round, battery is implanted around the vagus nerve in the neck.
• The result is that an electrical pulse is sent from this device into the neck, causing a reduction in seizures.
• Possible side effects of this device include voice hoarseness and discomfort in the throat.

Warning

Driving

In every Canadian province and territory, it is mandatory for potential drivers to report any health problems, including epilepsy. A medical board will review a person’s epilepsy condition and decide if they are competent to drive. Usually in Canada, patients must be seizure-free for two years in order to be deemed competent to drive.

Employment

Under the provincial human rights code, epileptics do not have to disclose their disorder. However, many feel the need to reveal this information once they are hired, largely for reasons of personal safety and because of insurance issues. The decision to divulge the disorder to the employer is a personal one, but it should be disclosed if seizures will affect the person on the job or if others are at risk.

Outlook

The outlook for epilepsy is good. Researchers at the National Institute of Health are hopeful that a cure will be found in 10 to 20 years.

Links

Epilepsy Toronto
Epilepsy Canada
Epilepsy Foundation