Epilepsy – Seizure Symptoms and Treatment of This Neurological Disorder

Epilepsy is a neurological disorder characterized by recurrent epileptic seizures. These seizures are caused by temporary disturbances in the brain’s electrical activity. Depending on the type of epilepsy, focal or generalized seizures may occur. Symptoms range from brief disturbances of consciousness to severe tonic-clonic seizures.

People with epilepsy can often achieve seizure freedom through modern treatment approaches and appropriate medications. Diagnosis is made using EEG, MRI, and other neurological tests.

Early diagnosis helps identify the cause of epilepsy and reduce the risk of further seizures. With personalized treatment, the quality of life for many people with epilepsy can be significantly improved.

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Quick Overview:

Epilepsy is a chronic neurological disorder of the brain characterized by recurrent seizures. Seizures can be focal or generalized and vary in severity. EEG, MRI, and a detailed description of the seizures play an important role in the diagnosis of epilepsy. Modern treatments enable many people with epilepsy to remain seizure-free over the long term.

Causes of Epilepsy

The causes of epilepsy have not yet been fully elucidated. However, researchers have identified several risk factors that increase the likelihood of an epileptic seizure.

These include:

Genetic risk factors, such as when parents currently have or have had epilepsy
Brain malformations
Prenatal brain damage
Stroke
Brain tumors
Meningitis
Poisoning
Medication, alcohol, and drug abuse

In some cases, no cause can be identified at all. These idiopathic forms of epilepsy are a very common type of the condition, affecting up to 40% of those with epilepsy.

Symptoms of Epilepsy

Epilepsy is a condition characterized by seizures. A seizure can last from seconds to minutes and usually occurs suddenly.

The presentation of epilepsy varies depending on the area of the brain affected. Therefore, it is not always easy to recognize a seizure. When an acute seizure occurs, epilepsy is always a medical emergency and requires medical treatment.

epileptic seizure

Sometimes, some of the following “warning signs” of an epileptic seizure may be noticed:

Mood swings
Irritability
Headaches, as well as
Hallucinations (visual auras)

Doctors generally distinguish between two basic forms of epilepsy:

Focal epilepsy

In this type of seizure, only a narrowly defined area of the cerebral cortex is initially affected. Depending on the function of this area, focal epilepsy can lead to a wide variety of symptoms. The most common are muscle twitching and perceptual disturbances. The patient may experience seizures while fully conscious or with impaired consciousness

Generalized epilepsy

A grand mal seizure is a generalized epileptic seizure that affects areas of both hemispheres of the brain. The best-known form of grand mal epilepsy is the tonic-clonic seizure, which proceeds in two phases. In the first phase, muscle spasms predominate. The patient is not conscious during this tonic phase. They fall to the ground with their arms and legs extended. The respiratory muscles may temporarily fail. This often results in a bluish discoloration of the skin (cyanosis). The second phase (clonic phase) follows the first phase after 10 to 30 seconds. In this part of the seizure, twitching dominates the clinical picture.

After one to two minutes, this phase of the seizure also subsides. The patient usually regains consciousness shortly afterward, then falls into a deep sleep from which it is difficult to wake them. Those affected may not remember the seizure itself after waking up. However, incontinence or biting the tongue are early signs of an epileptic seizure. Petit mal epilepsy, however, is much more difficult to diagnose. The person affected shows only a few seconds of inattention or absence, only to resume normal activity immediately afterward.

Petit mal or absence epilepsy may be indicated by the following signs:

Frequent blinking
Smacking of the lips
Turning the head backward or to the side
Head drooping

Special form: Epilepsy in children

A specific form of epilepsy occurs in children between the ages of two and eight months: West syndrome. Although it is rare, West syndrome must be taken seriously and usually has a poor prognosis.

It is characterized by:

Sudden seizures with rapid muscle twitches
Nodding seizures with neck stiffness, as well as
“Salaam” seizures with arms crossed in front of the chest

The cause is usually brain damage, so affected children generally suffer from a developmental disability.

Epilepsy is particularly common in childhood @ mjowra /AdobeStock

Treatment of Epilepsy

Neurologists typically diagnose and treat epilepsy. If a patient has already experienced several seizures, doctors should consider medication.

For most patients, these medications help them lead a seizure-free life. All available medications act on the nerve cells and prevent them from overreacting.

In some cases, patients are prescribed a combination of two different medications because one alone is not effective enough to control the symptoms. It is recommended to take the medications regularly to ensure a consistent level of the active ingredient in the blood and brain.

Doctors also recommend that people with epilepsy keep a seizure diary. This records the number and severity of epileptic seizures and makes it easier to track the course of treatment.

In cases where medication is not possible or is ineffective, surgery may be an option. If the seizures occur in the same area of the brain and doctors are able to remove it, then surgery is advisable. Otherwise, a type of “brain pacemaker” may be used to regulate the electrical discharges of the nerve cells. Medically, this procedure is referred to as deep brain stimulation.

Prognosis for Epilepsy

If an acute, organic cause of the epilepsy can be identified, the condition is usually treatable or even curable.

For many people with epilepsy, the cause of the condition cannot be identified. However, medication ensures that they remain seizure-free.

To prevent seizures, people with epilepsy should maintain a regular sleep routine and avoid using flickering lights in their homes.

Driving is permitted once a long period without seizures has passed. Otherwise, the driver’s license must be surrendered. Similarly, dangerous work involving heavy machinery or positions of responsibility (e.g., bus drivers, taxi drivers) should be suspended.

Which medical specialists treat epilepsy?

For epilepsy as well, there are experts available who specialize in the diagnosis, counseling, and treatment of this condition.

These experts work not only in specialized clinics but also in relevant hospital departments. Social workers, psychologists, and nurses who are members of the German Society for Epileptology (DGfE) are also included among them.

Depending on the location, the following types of facilities (hospitals or medical practices) can be distinguished:

Specialized epileptology practices
Epilepsy outpatient clinic
Epilepsy centers

For children or adolescents with epilepsy, pediatricians with specialized training in epileptology are the best point of contact.

FAQ

What is epilepsy?

Epilepsy is a neurological disorder characterized by recurrent epileptic seizures. However, a single epileptic seizure does not automatically mean that epilepsy is present. According to the criteria of the International League Against Epilepsy, the diagnosis is often made when at least two unprovoked seizures have occurred or there is an increased risk of further seizures. The condition can have various causes and encompass different forms of epilepsy.

What are the symptoms of epilepsy?

The symptoms depend on the specific form of epilepsy. Focal seizures initially affect specific nerve cells in the brain, while generalized seizures involve both halves of the brain. Typical symptoms include impaired consciousness, muscle twitching, auras, or a tonic-clonic seizure. Some seizures affect only individual muscles, while others affect the entire body. The duration and frequency of seizures can vary greatly from person to person.

How is epilepsy diagnosed?

The diagnosis of epilepsy is based on medical history, neurological examinations, and diagnostic tests. EEGs and MRIs are particularly important for identifying changes in the brain. The diagnostic process serves to determine the cause of epilepsy and to distinguish between focal and generalized epilepsy. It can also identify forms of epilepsy caused by genetic, structural, or symptomatic factors.

How is epilepsy treated?

Epilepsy is usually treated with antiepileptic medications. The goal of treatment is to achieve seizure freedom and prevent further seizures. If medication alone is not sufficient, specialized procedures or a ketogenic diet may be considered. The choice of treatment depends on the type of epilepsy, its cause, and the individual’s seizure frequency.

What is the life expectancy for people with epilepsy?

Many people with epilepsy have a normal life expectancy with proper treatment. The key factors are the cause of the condition, seizure control, and adherence to treatment. If epilepsy is not treated adequately, risks such as injuries or sudden unexpected death in epilepsy (SUDEP) may occur. Consistent treatment helps improve quality of life and reduce complications.